Empfohlen
Weitere ähnliche Inhalte
Was ist angesagt?
Was ist angesagt? (20)
Ähnlich wie BFRT
Ähnlich wie BFRT (20)
BFRT
- 1. Zac Lynch, SPT, CSCS Department of PhysicalTherapy EastTennessee State University
- 2. What are some common characteristics and deficits that we see with our patients in the clinic besides a presentation of pain?
- 4. Adjunct to training and rehabilitation that utilizes a piece of equipment to partially occlude arterial inflow and completely restrict venous outflow of blood in order to alter metabolic demands and endocrine response to improve strength and hypertrophy
- 5. ACSM and NSCA Guidelines: Strength ▪ Ability of a muscle or muscle group to exert a maximal external force ▪ Load: 60-70% 1RM for novice to intermediate; 80-100% for advanced ▪ Volume: 1-3 sets of 8-12 repetitions for novice to intermediate; 2-6 sets of 1-8 repetitions for advanced ▪ Rest period: 2-3 min for higher intense exercises that use heavier loads; 1-2 minutes between the lower intense exercises with light loads
- 7. Volume – 4 sets of an exercise 2 times/day produces greatest benefit Daily for two weeks vs. 2-3 times/week Done at end of a workout 30 - - 15 - - 15 - - 15 - - 15 Intensity 30% of 1RM (maximal work capacity) Rest 30 – 45 second rest Rhythm Varying tempo to promote more difficulty
- 8. Elderly/geriatric patients Deconditioning Disuse atrophy ACL rehabilitation Post-operative conditions not appropriate for loading Cardiac rehabilitation Strength training Hypertrophy Athletic populations Wounded warriors Pre-amputation strengthening Post-amputation strengthening Acute care OA/OP Chronic NSLBP with weakness Stress fracture/ligament/tendo n injury
- 10. Physiological Effects4 • Musculotendinous unit alterations • Endocrine system response • Systemic and cardiovascular response • Cellular adaptations
- 11. Switch from recruitment of aerobic muscle fibers to fast-twitch anaerobic muscle fibers due to the ischemic condition The isolated region undergoes a physiologic change to promote lactate and hydrogen ion production, while minimizing pH metabolite production
- 12. Increase in lactate promotes large amount of increase in growth hormone Growth hormone collagen synthesis Low pH levels sympathetic nn inc in growth hormone production in anterior pituitary Increase in IGF-1 Decrease in myostatin
- 14. Lack of oxygenation causes stimulation of satellite cells which travels to the localized area to help repair Increased venous compliance promoting increased post-exercise blood flow Shown to help decrease blood pressure in medicated hypertensive patients via hypotensive response Decreased stroke volume, SBP, DBP IncreasedVO2
- 15. Pooling of blood from occlusion can lead to cellular uptake of H20 and metabolites (IFG-1, lactate, acidic environment, GH) Produces an extreme anabolic environment The swelling of cells leads to prolonged response to the metabolites even after the occlusion is ceased Effects can take place up to 13 hours afterwards
- 16. Compression Bands Blood Flow Restriction Bands Occlusion Cuff DelphiTourniquet System
- 17. Cuff Placement Proximal upper extremity Proximal lower extremity Cuff Pressure Pulse – 80% of auscultation cutoff ▪ BP cuff – 140-240 mmHg LE, 100-160 mmHg UE Delphi – self measuring Bands – 4-5/UE, 6-7/10 LE
- 18. All strength exercises are options Bodyweight External resistance Open kinetic chain Closed kinetic chain NOTAN OPTION: Power exercises ▪ speed or jumping training
- 19. CONTRAINDICATIONS/PRECAU TIONS DVT Pregnancy Varicose veins High blood pressure Cardiac disease Rhabdomyolysis CONCERNS Subcutaneous hemorrhage Petechia Numbness Delayed onset muscle soreness “Cold feeling”
- 20. USAW Athlete – ACL Reconstruction with Allograft Rehabilitation consisted of BFRT after the initial inflammatory and acute phase Exercises with BFRT https://www.instagram.com/p/BAst3pzqzFh/?taken- by=jaredf94 https://www.instagram.com/p/BCvsSNaqzOf/?taken- by=jaredf94 https://www.instagram.com/p/BDWRV5oKzMF/?take n-by=jaredf94
- 22. Improvements in 1RM % Increase in isometric/isokinetic/isotonic strength Increase in local muscle endurance Increase in EMG activity Increase in proximal and distal muscle cross- sectional area
- 24. 1. Pope ZK,Willardson JM, Schoenfeld BJ. Exercise and blood flow restriction. J Strength Cond Res. 2013;27(10):2914-26. 2. Lorenz D, Morrison S. CURRENTCONCEPTS IN PERIODIZATIONOF STRENGTHAND CONDITIONING FORTHE SPORTS PHYSICAL THERAPIST. Int J Sports PhysTher. 2015;10(6):734-47. 3. Scott BR, Loenneke JP, Slattery KM, Dascombe BJ. Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports Med. 2015;45(3):313-25. 4. Loenneke JP,AbeT,Wilson JM, UgrinowitschC, Bemben MG. Blood flow restriction: how does it work?. Front Physiol. 2012;3:392. 5. Kang DY, Kim HS, Lee KS, KimYM.The effects of bodyweight-based exercise with blood flow restriction on isokinetic knee muscular function and thigh circumference in college students. J PhysTher Sci. 2015;27(9):2709-12. 6. Doessing S, Heinemeier KM, Holm L, et al. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis. J Physiol (Lond). 2010;588(Pt 2):341-51.
- 25. 7. Park SY, KwakYS, Harveson A,Weavil JC, Seo KE. Low intensity resistance exercise training with blood flow restriction: insight into cardiovascular function, and skeletal muscle hypertrophy in humans. Korean J Physiol Pharmacol. 2015;19(3):191-6. 8. Pearson SJ, Hussain SR. A review on the mechanisms of blood-flow restriction resistance training-induced muscle hypertrophy. Sports Med. 2015;45(2):187- 200. 9. O’Halloran J, Campbell B, Martinez N, et al.The effects of practical vascular blood flow restriction training on skeletal muscle hypertrophy. Journal of the International Society of Sports Nutrition. 2014;11(Suppl 1):P18. doi:10.1186/1550-2783-11-S1-P18. 10. NakajimaT, Kurano M, Iida H. Use and safety of KAATSU training: results of a national survey. Int J KAATSUTrain Res. 2006. 2 (1): 5–13. 11. Loenneke JP,Wilson JM,Wilson GJ, PujolTJ, Bemben MG. Potential safety issues with blood flow restriction training. Scand J Med Sci Sports, 2011. 21: 510- 518. 12. Loenneke JP,Thiebaud RS, AbeT. Does blood flow restriction result in skeletal muscle damage? A critical review of available evidence. Scand J Med Sci Sports, 2014. 25(4): 521-534.
Hinweis der Redaktion
- Strength Strength helps prevent future injury Rehab quicker from current injury Engage in activities without compensation Allow for return to ADLs and occupation demands Improve confidence and self esteem
- Tourniquet/occlusion device/blood pressure cuff. In a clinic, we should use FDA approved device that can be purchased which has dial readings to monitor pressure, this is placed on proximal limb to where the target exercise will be stressing specific injured muscle fibers
- Also in rehab we want to improve power as this is much more functional, and research has shown that improving strength with blocked practice can lead to improvements in power we have to use relatively intense weight and external loads in order to promote improvements in strength, endurance, and hypertrophy.
- How do we find a 1RM for an individual in the clinic? Well we utilize light weight and perform maximal repetitions, this can then be used to calculate the 1RM and we then percentize that to formulate the training program End of workout - Potential for increased tissue recovery secondary to increased muscle protein synthesis without additional muscle damage More difficult if there is longer eccentric contraction, each position should be no longer than 5 seconds as this exercise should be completed in 5-8 minutes maximum
- Type 1 fibers usually recrutied first in light loads and resistanc exercise, but the restriction of blood causes the type 1 to be exhaused and fatigued then leading to the quicker recruitment of type II fibers which are utilized and broken down to begin the reparative stage of healing and growing stronger Fast twitch are phsiologically known to be able to increase in size due to the synthesis of cells rather than the enlargement of a single cell or myofibril
- Lactate acid is accumulated from the effect of minimal oxygenation, thus relying on the cori cycle for energy production and using cellular glucose for energy, thus giving off the byproduct of lactate which pools in the same area as the venous outflow is reduced and cannot return to the kidney Growth hormone has no effect on protein synthesis IGF-1 directly related to large increases in mm protein synthesis Myostatin inhibits mm growth and differentiation
- The extremely therapeutic effects come from the combination of increased GH which strengthens and improves the quality of the tendons and ligaments, while the IGF promotes cell proliferation and protein synthesis, and the decrease in myostatic helps to provide an environment that can grow and differentiate without being inhibited and altered at the cellular level (similar effect that cortisol has) We don’t even have mm protein breakdown, so the effect of DOMS may be minimal, however some research displays significant DOMS, so it should be judged based on the patients history and sedentary lifestyle, educate about DOMS
- Satelitte cells normally stim when there is mm damage, so this effect, like GH promotes a healthy environment while increasing strength Caution should be taken with individuals not stable with BP and having previous arrhythmias or MI Increase in HR and BP during the exercise, so be weary and careful during intrasets and during the actual lifting, monitor perceieved rate of exertion and dizziness and fatigue VO2 increased with walking
- Anti-catabolic environment, so this causes increased healing, size, strength of the musculotendinous junction and ligaments in the area
- Compression bands – voodoo floss, very cheap 4-5/10 for UE, 6-7/10 for LE poor reliability when doing multiple workouts of the same occlusion level BFR bands level of occlusion cant be reliably reproduced and these are commonly very thin so the pressure of the band is put through smaller area and can compress nn easier (nn paralysis) if do choose these need thick so 1/3 of the extremity length Occlusion cuff 125$ wide enough can measure level of occlusion, leading to reliability and standardization Delphi System gold standard from owensrecoveryscience has doppler ultrasound to alow for accurate measurement of blood flow into extremities safety feasures to rapidly shut off if needed, has automatic times only FDA approved devise so we are legally safe using this
- Pressure of 40-50% arterial occlusion actually increased muscle activation Delphi – 50% occlusion UE and 80% LE for complete venous occulsion and 70-80% arterial
- Has been shown that it actually prevents blood clots and helps to decrease swelling due to the activation of antithrombin and other anti-coagualation factors Hypertensino has been shown in some studies to have a positive effect as there is a hypotension effect after removal of the device Cardiac disease due to the
- BFRT during bed rest BFRT plus low workload walking BFRT plus low load resistance exercise BFRT plus high load resistance exercise
- This is a snapshot from the athletes page where he reports that after 11 weeks his repaired right lower extremity is 1 inch larger in circumference at the quadriceps region that his unrepaired leg.
- – 1RM max – isometric strength – isokinetic strength – muscular endurance – postactivation potential – EMG activity – cross-sectional area (CSA)