OpenLB
Open Library of Bioscience
Advanced Search
Medicine and science in sports and exercise
05 01, 2023;55 (5): 920-931.

Effects of Sex and Cuff Pressure on Physiological Responses during Blood Flow Restriction Resistance Exercise in Young Adults.

Sylvie M Gray, Amanda M Cuomo, Christopher E Proppe, Miranda K Traylor, Ethan C Hill, Joshua L Keller
Author Information
  1. Sylvie M Gray: Integrated Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL.
  2. Christopher E Proppe: Division of Kinesiology, School of Kinesiology and Physical Therapy, University of Central Florida, Orlando, FL.
  3. Miranda K Traylor: Integrated Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL.
  4. Joshua L Keller: Integrated Laboratory of Exercise and Applied Physiology (iLEAP), Department of Health, Kinesiology and Sport, College of Education and Professional Studies, University of South Alabama, Mobile, AL.
PMID: 36729632 DOI: 10.1249/MSS.0000000000003103

Abstract

PURPOSE: The purpose of this study was to examine the physiological responses resulting from an acute blood flow restriction resistance exercise bout with two different cuff pressures in young, healthy men and women.
METHODS: Thirty adults (18-30 yr) completed a bilateral leg extension blood flow restriction bout consisting of four sets (30-15-15-15 repetitions), with cuffs applied at pressures corresponding to 40% and 60% of the minimum arterial occlusion pressure (AOP) needed to completely collapse the femoral arteries. During each of these conditions (40% and 60% AOP), physiological measures of near-infrared spectroscopy (NIRS) and EMG amplitude (EMG AMP) were collected from the dominant or nondominant vastus lateralis. After each set, ratings of perceived exertion (RPE) were collected, whereas only at baseline and at the end of the bout, mean arterial pressure (MAP) was assessed. Separate mixed-factorial ANOVA models were used to examine mean differences in the change in EMG AMP and NIRS parameters during each set. The absolute RPE and MAP values were also examined with separate ANOVAs. A P value ≤0.05 was considered statistically significant.
RESULTS: Regardless of sex or cuff pressure, the change in EMG AMP was lower in set 1 (14.8%) compared with the remaining sets (22.6%-27.0%). The 40% AOP condition elicited the greatest changes in oxy[heme] and deoxy[heme], while also providing lower RPEs. For MAP, there was an effect for time such that MAP increased from preexercise (87.5 ± 4.3 mm Hg) to postexercise (104.5 ± 4.1 mm Hg).
CONCLUSIONS: The major findings suggested that the 40% AOP condition permitted the greatest amount of recovery during the interset rest. In addition, there did not seem to be any meaningful sex-related difference in this sample of young healthy adults.

References

  1. Hill EC, Rivera PM, Proppe CE, Gonzalez Rojas DH, Wizenberg AM, Keller JL. Greater neuromuscular fatigue following low-load blood flow restriction than non-blood flow restriction resistance exercise among recreationally active men. J Neurophysiol . 2022;128(1):73–85.
  2. Martin PM, Bart RM, Ashley RL, Velasco T, Wise SR. An overview of blood flow restriction physiology and clinical considerations. Curr Sports Med Rep . 2022;21(4):123–8.
  3. Mattocks KT, Jessee MB, Mouser JG, et al. The application of blood flow restriction: lessons from the laboratory. Curr Sports Med Rep . 2018;17(4):129–34.
  4. Das A, Paton B. Is there a minimum effective dose for vascular occlusion during blood flow restriction training? Front Physiol . 2022;13:838115.
  5. Kambic T, Jug B, Piepoli MF, Lainscak M. Is blood flow restriction resistance training the missing piece in cardiac rehabilitation of frail patients? Eur J Prev Cardiol . 2023;30(2):117–22.
  6. Clarkson MJ, May AK, Warmington SA. Is there rationale for the cuff pressures prescribed for blood flow restriction exercise? A systematic review. Scand J Med Sci Sports . 2020;30(8):1318–36.
  7. Reis JF, Fatela P, Mendonca GV, et al. Tissue oxygenation in response to different relative levels of blood-flow restricted exercise. Front Physiol . 2019;10:407.
  8. Lixandrão ME, Ugrinowitsch C, Laurentino G, et al. Effects of exercise intensity and occlusion pressure after 12 weeks of resistance training with blood-flow restriction. Eur J Appl Physiol . 2015;115(12):2471–80.
  9. Counts BR, Dankel SJ, Barnett BE, et al. Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation. Muscle Nerve . 2016;53(3):438–45.
  10. Jessee MB, Buckner SL, Mouser JG, et al. Muscle adaptations to high-load training and very low-load training with and without blood flow restriction. Front Physiol . 2018;9:1448.
  11. Mouser JG, Mattocks KT, Buckner SL, et al. High-pressure blood flow restriction with very low load resistance training results in peripheral vascular adaptations similar to heavy resistance training. Physiol Meas . 2019;40(3):035003.
  12. Counts BR, Rossow LM, Mattocks KT, et al. Let’s talk about sex: where are the young females in blood flow restriction research? Clin Physiol Funct Imaging . 2018;38(1):1–3.
  13. Landen S, Hiam D, Voisin S, Jacques M, Lamon S, Eynon N. Physiological and molecular sex differences in human skeletal muscle in response to exercise training. J Physiol . 2023;601(3):419–34.
  14. Parra ME, Sterczala AJ, Miller JD, Trevino MA, Dimmick HL, Herda TJ. Sex-related differences in motor unit firing rates and action potential amplitudes of the first dorsal interosseous during high-, but not low-intensity contractions. Exp Brain Res . 2020;238(5):1133–44.
  15. Freitas EDS, Galletti BRA, Koziol KJ, et al. The acute physiological responses to traditional vs. practical blood flow restriction resistance exercise in untrained men and women. Front Physiol . 2020;11:577224.
  16. Wernbom M, Aagaard P. Muscle fibre activation and fatigue with low-load blood flow restricted resistance exercise—an integrative physiology review. Acta Physiol (Oxf) . 2020;228(1):e13302.
  17. Singer TJ, Stavres J, Elmer SJ, et al. Knee extension with blood flow restriction: impact of cuff pressure on hemodynamics. Eur J Appl Physiol . 2020;120(1):79–90.
  18. Vigotsky AD, Halperin I, Lehman GJ, Trajano GS, Vieira TM. Interpreting signal amplitudes in surface electromyography studies in sport and rehabilitation sciences. Front Physiol . 2018;8:985.
  19. Hureau TJ, Broxterman RM, Weavil JC, Lewis MT, Layec G, Amann M. On the role of skeletal muscle acidosis and inorganic phosphates as determinants of central and peripheral fatigue: a 31 P-MRS study. J Physiol . 2022;600(13):3069–81.
  20. Yasuda T, Abe T, Brechue WF, et al. Venous blood gas and metabolite response to low-intensity muscle contractions with external limb compression. Metabolism . 2010;59(10):1510–9.
  21. Yasuda T, Brechue WF, Fujita T, Shirakawa J, Sato Y, Abe T. Muscle activation during low-intensity muscle contractions with restricted blood flow. J Sports Sci . 2009;27(5):479–89.
  22. Drouin PJ, Forbes SPA, Liu T, Lew LA, McGarity-Shipley E, Tschakovsky ME. Muscle contraction force conforms to muscle oxygenation during constant-activation voluntary forearm exercise. Exp Physiol . 2022;107(11):1360–74.
  23. Keller JL, Anders JPV, Neltner TJ, Housh TJ, Schmidt RJ, Johnson GO. Sex differences in muscle excitation and oxygenation, but not in force fluctuations or active hyperemia resulting from a fatiguing, bilateral isometric task. Physiol Meas . 2021;42(11):115004.
  24. Cristina-Oliveira M, Meireles K, Spranger MD, O’Leary DS, Roschel H, Peçanha T. Clinical safety of blood flow-restricted training? A comprehensive review of altered muscle metaboreflex in cardiovascular disease during ischemic exercise. Am J Physiol Heart Circ Physiol . 2020;318(1):H90–109.
  25. Keller JL, Kennedy KG, Hill EC, Fleming SR, Colquhoun RJ, Schwarz NA. Handgrip exercise induces sex-specific mean arterial pressure and oxygenation responses but similar performance fatigability. Clin Physiol Funct Imaging . 2022;42(2):127–38.
  26. Lee JB, Notay K, Seed JD, Nardone M, Omazic LJ, Millar PJ. Sex differences in muscle metaboreflex activation after static handgrip exercise. Med Sci Sports Exerc . 2021;53(12):2596–604.
  27. Spitz RW, Wong V, Bell ZW, et al. Blood flow restricted exercise and discomfort: a review. J Strength Cond Res . 2022;36(3):871–9.
  28. Mattocks KT, Jessee MB, Counts BR, et al. The effects of upper body exercise across different levels of blood flow restriction on arterial occlusion pressure and perceptual responses. Physiol Behav . 2017;171:181–6.
  29. Suga T, Dora K, Mok E, et al. Exercise adherence-related perceptual responses to low-load blood flow restriction resistance exercise in young adults: a pilot study. Physiol Rep . 2021;9(23):e15122.
  30. Suchomel TJ, Nimphius S, Bellon CR, Stone MH. The importance of muscular strength: training considerations. Sports Med . 2018;48(4):765–85.
  31. Noboa K, Keller J, Hergenrader K, et al. Men exhibit greater pain pressure thresholds and times to task failure but not performance fatigability following self-paced exercise. Percept Mot Skills . 2021;128(5):2326–45.
  32. Limberg JK, Eldridge MW, Proctor LT, Sebranek JJ, Schrage WG. Alpha-Adrenergic control of blood flow during exercise: effect of sex and menstrual phase. J Appl Physiol (1985) . 2010;109(5):1360–8.
  33. Mattu AT, MacInnis MJ, Doyle-Baker PK, Murias JM. Effects of the menstrual and oral contraceptive cycle phases on microvascular reperfusion. Exp Physiol . 2020;105(1):184–91.
  34. Lynn BM, McCord JL, Halliwill JR. Effects of the menstrual cycle and sex on postexercise hemodynamics. Am J Physiol Regul Integr Comp Physiol . 2007;292(3):R1260–70.
  35. Smith JR, Koepp KE, Berg JD, Akinsanya JG, Olson TP. Influence of sex, menstrual cycle, and menopause status on the exercise pressor reflex. Med Sci Sports Exerc . 2019;51(5):874–81.
  36. Blagrove RC, Bruinvels G, Pedlar CR. Variations in strength-related measures during the menstrual cycle in eumenorrheic women: a systematic review and meta-analysis. J Sci Med Sport . 2020;23(12):1220–7.
  37. Ryan TE, Erickson ML, Brizendine JT, Young HJ, McCully KK. Noninvasive evaluation of skeletal muscle mitochondrial capacity with near-infrared spectroscopy: correcting for blood volume changes. J Appl Physiol (1985) . 2012;113(2):175–83.
  38. Tinsley GM, Moore ML, Benavides ML, Dellinger JR, Adamson BT. 3-Dimensional optical scanning for body composition assessment: a 4-component model comparison of four commercially available scanners. Clin Nutr . 2020;39(10):3160–7.
  39. Barstow TJ. Understanding near infrared spectroscopy and its application to skeletal muscle research. J Appl Physiol (1985) . 2019;126(5):1360–76.
  40. Noble B, Robertson R. The Borg Scale: Development, Administration, and Experimental Use . Champaign (IL): Human Kinetics; 1996.
  41. Marcora S. Perception of effort during exercise is independent of afferent feedback from skeletal muscles, heart, and lungs. J Appl Physiol (1985) . 2009;106(6):2060–2.
  42. Bergevin M, Steele J, Payen de la Garanderie M, et al. Pharmacological blockade of muscle afferents and perception of effort: a systematic review with meta-analysis. Sports Med . 2023;53(2):415–35.
  43. Steele J, Fisher J, McKinnon S, McKinnon P. Differentiation between perceived effort and discomfort during resistance training in older adults: reliability of trainee ratings of effort and discomfort, and reliability and validity of trainer ratings of trainee effort. J Trainology . 2016;6(1):1–8.
  44. Steele J, Fisher J. Effort, discomfort, group III/IV afferents, bioenergetics, and motor unit recruitment. Med Sci Sports Exerc . 2018;50(8):1718.
  45. Hutchinson J, Tenenbaum G. Perceived effort and exertion. In: Labbé EE, Petrie TA, Petruzello SJ, Steinfeldt JA, editors. APA Handbook of Sport and Exercise Psychology. Vol. 2 . Washington (DC): American Psychological Association; 2019. pp. 159–82.
  46. Broxterman RM, Layec G, Hureau TJ, et al. Bioenergetics and ATP synthesis during exercise: role of group III/IV muscle afferents. Med Sci Sports Exerc . 2017;49(12):2404–13.
  47. Anders JPV, Neltner TJ, Keller JL, Housh TJ, Schmidt RJ, Johnson GO. Are mode-specific differences in performance fatigability attributable to muscle oxygenation? Eur J Appl Physiol . 2021;121(8):2243–52.
  48. Keller JL, Kennedy KG. Men exhibit faster skeletal muscle tissue desaturation than women before and after a fatiguing handgrip. Eur J Appl Physiol . 2021;121(12):3473–83.
  49. Dankel SJ, Buckner SL, Counts BR, et al. The acute muscular response to two distinct blood flow restriction protocols. Physiol Int . 2017;104(1):64–76.
  50. de Morree HM, Klein C, Marcora SM. Perception of effort reflects central motor command during movement execution. Psychophysiology . 2012;49(9):1242–53.
  51. Farina D, Merletti R, Enoka RM. The extraction of neural strategies from the surface EMG: an update. J Appl Physiol (1985) . 2014;117(11):1215–30.
  52. Jessee MB, Mattocks KT, Buckner SL, et al. Mechanisms of blood flow restriction: the new testament. Tech Orthop . 2018;33(2):72–9.
  53. Loenneke JP, Thiebaud RS, Abe T, Bemben MG. Blood flow restriction pressure recommendations: the hormesis hypothesis. Med Hypotheses . 2014;82(5):623–6.
  54. Haizlip KM, Harrison BC, Leinwand LA. Sex-based differences in skeletal muscle kinetics and fiber-type composition. Physiology (Bethesda) . 2015;30(1):30–9.
  55. Ansdell P, Thomas K, Hicks KM, Hunter SK, Howatson G, Goodall S. Physiological sex differences affect the integrative response to exercise: acute and chronic implications. Exp Physiol . 2020;105(12):2007–21.
  56. Loenneke JP, Kim D, Fahs CA, et al. The effects of resistance exercise with and without different degrees of blood-flow restriction on perceptual responses. J Sports Sci . 2015;33(14):1472–9.
  57. Rivera PM, Proppe CE, Beltran E, Hill EC. Acute effects of local ischemic hypoxia and systemic hypoxemia on neuromuscular and cognitive function. High Alt Med Biol . 2022;23(1):18–25.
  58. Patterson SD, Hughes L, Warmington S, et al. Blood flow restriction exercise: considerations of methodology, application, and safety. Front Physiol . 2019;10:533.
  59. Biazon TMPC, Ugrinowitsch C, Soligon SD, et al. The association between muscle deoxygenation and muscle hypertrophy to blood flow restricted training performed at high and low loads. Front Physiol . 2019;10:446.
  60. Suga T, Okita K, Morita N, et al. Dose effect on intramuscular metabolic stress during low-intensity resistance exercise with blood flow restriction. J Appl Physiol (1985) . 2010;108(6):1563–7.
  61. Spitz RW, Chatakondi RN, Bell ZW, et al. Blood flow restriction exercise: effects of sex, cuff width, and cuff pressure on perceived lower body discomfort. Percept Mot Skills . 2021;128(1):353–74.
  62. Steele J. What is (perception of) effort? Objective and subjective effort during attempted task performance. PsyArXiv . 2020. Available from: https://psyarxiv.com/kbyhm/ .

MeSH Term

Male
Humans
Female
Young Adult
Resistance Training
Hemodynamics
Quadriceps Muscle
Femoral Artery
Heme
Regional Blood Flow
Muscle, Skeletal
Blood Pressure

Chemicals

Heme
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 3

Word Cloud

Created with Highcharts 10.0.040%AOPEMGMAPboutpressureAMPsetexaminephysiologicalbloodflowrestrictioncuffpressuresyounghealthyadultssets60%arterialNIRScollectedRPEmeanchangealsolower1conditiongreatest5±4mmHgPURPOSE:purposestudyresponsesresultingacuteresistanceexercisetwodifferentmenwomenMETHODS:Thirty18-30yrcompletedbilaterallegextensionconsistingfour30-15-15-15repetitionscuffsappliedcorrespondingminimumocclusionneededcompletelycollapsefemoralarteriesconditionsmeasuresnear-infraredspectroscopyamplitudedominantnondominantvastuslateralisratingsperceivedexertionwhereasbaselineendassessedSeparatemixed-factorialANOVAmodelsuseddifferencesparametersabsolutevaluesexaminedseparateANOVAsPvalue≤005consideredstatisticallysignificantRESULTS:Regardlesssex148%comparedremaining226%-270%elicitedchangesoxy[heme]deoxy[heme]providingRPEseffecttimeincreasedpreexercise873postexercise104CONCLUSIONS:majorfindingssuggestedpermittedamountrecoveryintersetrestadditionseemmeaningfulsex-relateddifferencesampleEffectsSexCuffPressurePhysiologicalResponsesBloodFlowRestrictionResistanceExerciseYoungAdults

Similar Articles

Cited By