Download PDF
Int J Sports Med 2021; 42(07): 577-587
DOI: 10.1055/a-1386-4846
Review

Resistance Training with Blood Flow Restriction on Vascular Function: A Meta-analysis

Yujia Liu  ‡
1   Department of Physical Education, Jiangsu Normal University, Xuzhou, China
,
Ning Jiang‡
2   Department of Orthopedics, Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
,
Fangfang Pang
3   Department of Emergency, Haigang Hospital of Yantai City, Yantai, China
,
Tong Chen
4   Department of Marxism Studies, Jiangsu Normal University, Xuzhou, China
› Author Affiliations Funding: This analysis was based upon work funded by the Jiangsu Provincial Natural Science Foundation for Youth of China under Grant No. BK20190999
› Further Information
Also available at
    Permissions and Reprints

Abstract

In this meta-analysis, the aims were to examine the effects of resistance training with and without blood flow restriction on vascular function. Five databases were searched up to June 2020 for papers about resistance training with blood flow restriction influence on vascular function. The quality of each identified study was evaluated. Effect sizes were estimated in terms of the standardized mean difference. A subgroup analysis was conducted according to participants’ age, training duration, and cuff pressure. The results of six studies on arterial compliance and five on vascular function were highly homogenous regarding responses to resistance training with or without blood flow restriction. Resistance training with blood flow restriction had a more positive effect for regulating arterial compliance than resistance training without blood flow restriction, but not for vascular function. Resistance training with blood flow restriction leads to a more positive effect on vascular function than resistance training when training for no longer than four weeks.

Key words

blood flow restriction - arterial compliance - vascular function - metaanalysis - resistance training

* Joint first authors.


Supplementary Material



Publication History

Received: 26 August 2020

Accepted: 29 January 2021

Article published online:
18 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Tschakovsky ME, Sheriff DD. Immediate exercise hyperemia: contributions of the muscle pump vs. rapid vasodilation. J Appl Physiol (1985) 2004; 97: 739-747
    CrossrefPubMedGoogle Scholar
  • 2 Liberson AS, Lillie JS, Day SW. et al. A physics based approach to the pulse wave velocity prediction in compliant arterial segments. J Biomech 2016; 49: 3460-3466
    CrossrefPubMedGoogle Scholar
  • 3 Battistoni A, Michielon A, Marino G. et al. Vascular aging and central aortic blood pressure: from pathophysiology to treatment. High Blood Press Cardiovasc Prev 2020; 27: 299-308
    CrossrefPubMedGoogle Scholar
  • 4 Berry KL, Cameron JD, Dart AM. et al. Large-artery stiffness contributes to the greater prevalence of systolic hypertension in elderly women. J Am Geriatr Soc 2004; 52: 368-373
    CrossrefPubMedGoogle Scholar
  • 5 Zito C, Manganaro R, Carerj S. et al. Peripheral artery disease and stroke. J Cardiovasc Echogr 2020; 30: S17-S25
    CrossrefPubMedGoogle Scholar
  • 6 Birudaraju D, Cherukuri L, Kinninger A. et al. Relationship between cardio-ankle vascular index and obstructive coronary artery disease. Coron Artery Dis 2020; 31: 550-555
    CrossrefPubMedGoogle Scholar
  • 7 Baumgartner L, Weberruß H, Oberhoffer-Fritz R. et al. Vascular structure and function in children and adolescents: what impact do physical activity, health-related physical fitness, and exercise have?. Front Pediatr 2020; 8: 103
    CrossrefPubMedGoogle Scholar
  • 8 Ercan M, Koksal C. The relationship between shear rate and vessel diameter. Anesth Analg 2003; 96: 307. author reply 307-308
    CrossrefPubMedGoogle Scholar
  • 9 Tschakovsky ME. Immediate exercise hyperemia in humans is contraction intensity dependent: Evidence for rapid vasodilation. J Appl Physiol (1985) 2004; 96: 639-644
    CrossrefPubMedGoogle Scholar
  • 10 Shimizu R, Hotta K, Yamamoto S. et al. Low-intensity resistance training with blood flow restriction improves vascular endothelial function and peripheral blood circulation in healthy elderly people. Eur J Appl Physiol 2016; 116: 749-757
    CrossrefPubMedGoogle Scholar
  • 11 Clark BC, Manini TM, Hoffman RL. et al. Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults. Scand J Med. Sci Sports 2011; 21: 653-662
    PubMedGoogle Scholar
  • 12 Takarada Y, Takazawa H, Sato Y. et al. Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol (1985) 2000; 88: 2097-2106
    CrossrefPubMedGoogle Scholar
  • 13 Karabulut M, Abe T, Sato Y. et al. The effects of low-intensity resistance training with vascular restriction on leg muscle strength in older men. Eur J Appl Physiol (1985) 2010; 108: 147-155
    CrossrefPubMedGoogle Scholar
  • 14 Bigdeli S, Dehghaniyan MH, Amani-Shalamzari S. et al. Functional training with blood occlusion influences muscle quality indices in older adults. Arch Gerontol Geriatr 2020; 90: 104110
    CrossrefPubMedGoogle Scholar
  • 15 Yudai T, Yutaka N, Seiji A. et al. Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion. J Appl Physiol (1985) 2000; 88: 61-65
    CrossrefPubMedGoogle Scholar
  • 16 Patterson SD, Leggate M. Circulating hormone and cytokine response to low-load resistance training with blood flow restriction in older men. Eur J Appl Physiol 2013; 113: 713-719
    CrossrefPubMedGoogle Scholar
  • 17 Kim SJ, Sherk VD, Bemben MG. et al. Effects of short-term, low-intensity resistance training with vascular restriction on arterial compliance in untrained young men. Int J Kaatsu Train Res 2009; 5: 1-8
    CrossrefPubMedGoogle Scholar
  • 18 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: 35003
    CrossrefPubMedGoogle Scholar
  • 19 Bond V, Curry BH, Kumar K. et al. Restricted blood flow exercise in sedentary, overweight African-American females may increase muscle strength and decrease endothelial function and vascular autoregulation. J Pharmacopuncture 2017; 20: 23-28
    CrossrefPubMedGoogle Scholar
  • 20 Ozaki H, Miyachi M, Nakajima T. et al. Effects of 10 weeks walk training with leg blood flow reduction on carotid arterial compliance and muscle size in the elderly adults. Angiology 2011; 62: 81-86
    CrossrefPubMedGoogle Scholar
  • 21 Shamseer L, Moher D, Clarke M. et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: Elaboration and explanation. BMJ 2015; 350: g7647
    CrossrefPubMedGoogle Scholar
  • 22 Smart NA, Waldron M, Ismail H. et al. Validation of a new tool for the assessment of study quality and reporting in exercise training studies: TESTEX. Int J Evid Based Healthc 2015; 13: 9-18
    CrossrefPubMedGoogle Scholar
  • 23 Fahs CA, Rossow LM, Loenneke JP. et al. Effect of different types of lower body resistance training on arterial compliance and calf blood flow. Clin Physiol Funct Imaging 2012; 32: 45-51
    CrossrefPubMedGoogle Scholar
  • 24 Ozaki H, Yasuda T, Ogasawara R. et al. Effects of high-intensity and blood flow-restricted low-intensity resistance training on carotid arterial compliance: Role of blood pressure during training sessions. Eur J Appl Physiol 2013; 113: 167-174
    CrossrefPubMedGoogle Scholar
  • 25 Yasuda T, Fukumura K, Uchida Y. et al. Effects of low-load, elastic band resistance training combined with blood flow restriction on muscle size and arterial stiffness in older adults. J Gerontol A Biol Sci Med Sci 2015; 70: 950-958
    CrossrefPubMedGoogle Scholar
  • 26 Yasuda T, Fukumura K, Iida H. et al. Effects of detraining after blood flow-restricted low-load elastic band training on muscle size and arterial stiffness in older women. Springerplus 2015; 4: 348
    CrossrefPubMedGoogle Scholar
  • 27 Ramis TR, Muller CH, de L, Boeno FP. et al. Effects of traditional and vascular restricted strength training program with equalized volume on isometric and dynamic strength, muscle thickness, electromyographic activity, and endothelial function adaptations in young adults. J strength Cond Res 2020; 34: 689-698
    CrossrefPubMedGoogle Scholar
  • 28 Grønfeldt BM, Lindberg Nielsen J, Mieritz RM. et al. Effect of blood-flow restricted vs heavy-load strength training on muscle strength: Systematic review and meta-analysis. Scand J Med Sci Sports 2020; 30: 837-848
    CrossrefPubMedGoogle Scholar
  • 29 Wong ML, Formiga MF, Owens J. et al. Safety of blood flow restricted exercise in hypertension: A meta-analysis and systematic review with potential applications in orthopedic care. Tech Orthop 2018; 33: 80-88
    CrossrefPubMedGoogle Scholar
  • 30 Miyachi M. Effects of resistance training on arterial stiffness: A meta-analysis. Br J Sports Med 2013; 47: 393-396
    CrossrefPubMedGoogle Scholar
  • 31 Raastad T, Glomsheller T, Bjøro T. et al. Changes in human skeletal muscle contractility and hormone status during 2 weeks of heavy strength training. Eur J Appl Physiol 2001; 84: 54-63
    CrossrefPubMedGoogle Scholar
  • 32 Spranger MD, Krishnan AC, Levy PD. et al. Blood flow restriction training and the exercise pressor reflex: A call for concern. Am J Physiol Heart Circ Physiol 2015; 309: H1440-H1452
    CrossrefPubMedGoogle Scholar
  • 33 Domingos E, Polito MD. Blood pressure response between resistance exercise with and without blood flow restriction: A systematic review and meta-analysis. Life Sci 2018; 209: 122-131
    CrossrefPubMedGoogle Scholar
  • 34 Loenneke JP, Wilson JM, Wilson GJ. et al. Potential safety issues with blood flow restriction training. Scand J Med Sci Sports 2011; 21: 510-518
    CrossrefPubMedGoogle Scholar
  • 35 Fortier C, Sidibé A, Desjardins M-P. et al. Aortic-brachial pulse wave velocity ratio: A blood pressure-independent index of vascular aging. Hypertension. 2017; 69: 96-101
    PubMedGoogle Scholar
  • 36 Hellsten Y, Hoier B. Capillary growth in human skeletal muscle: physiological factors and the balance between pro-angiogenic and angiostatic factors. Biochem Soc Trans 2014; 42: 1616-1622
    CrossrefPubMedGoogle Scholar
  • 37 Ferguson RA, Hunt JEA, Lewis MP. et al. The acute angiogenic signalling response to low-load resistance exercise with blood flow restriction. Eur J Sport Sci 2018; 18: 397-406
    CrossrefPubMedGoogle Scholar
  • 38 Sharifi S, Monazzami A, Nikousefat Z. et al. The acute and chronic effects of resistance training with blood flow restriction on hormonal responses in untrained young men: A comparison of frequency. Cell Mol Biol (Noisy-le-grand) 2020; 66: 1-8
    CrossrefPubMedGoogle Scholar
  • 39 Shweiki D, Itin A, Soffer D. et al. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature 1992; 359: 843-845
    CrossrefPubMedGoogle Scholar
  • 40 Stein I, Neeman M, Shweiki D. et al. Stabilization of vascular endothelial growth factor mRNA by hypoxia and hypoglycemia and coregulation with other ischemia-induced genes. Mol Cell Biol 1995; 15: 5363-5368
    CrossrefPubMedGoogle Scholar
  • 41 Behjati A, No ABM, Faramarzi M. The effect of resistance training on Vascular Endothelial Growth Factor (VEGF) in older women. Salmand: Iranian Journal of Ageing 2015; 10: 156-165
    PubMedGoogle Scholar
  • 42 Paula SM, Fernandes T, Couto GK. et al. Molecular pathways involved in aerobic exercise training enhance vascular relaxation. Med Sci Sports Exerc 2020; 52: 2117-2126
    CrossrefPubMedGoogle Scholar
  • 43 Green DJ, Spence A, Halliwill JR. et al. Exercise and vascular adaptation in asymptomatic humans. Exp Physiol 2011; 96: 57-70
    CrossrefPubMedGoogle Scholar
  • 44 Johnson LR, Rush JW, Turk JR. et al. Short-term exercise training increases ACh-induced relaxation and eNOS protein in porcine pulmonary arteries. J Appl Physiol (1985) 2001; 90: 1102-1110
    CrossrefPubMedGoogle Scholar
  • 45 Johnson LR, Laughlin MH. Chronic exercise training does not alter pulmonary vasorelaxation in normal pigs. J Appl Physiol (1985) 2000; 88: 2008-2014
    CrossrefPubMedGoogle Scholar
  • 46 Spence AL, Carter HH, Naylor LH. et al. A prospective randomized longitudinal study involving 6 months of endurance or resistance exercise. Conduit artery adaptation in humans. J Physiol 2013; 591: 1265-1275
    PubMedGoogle Scholar
  • 47 Park S-Y, Kwak YS, Harveson A. et al. 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: 191-196
    CrossrefPubMedGoogle Scholar
  • 48 Harriss DJ, MacSween A, Atkinson G. Ethical standards in sport and exercise science research: 2020 Update. Int J Sports Med 2019; 40: 813-817
    Article in Thieme ConnectPubMedGoogle Scholar
  • 49 Greig CA, Young A, Skelton DA. et al. Exercise studies with elderly volunteers. Age Ageing 1994; 23: 185-189
    CrossrefPubMedGoogle Scholar