The team at SPORT PT is excited to be offering Personalized Blood Flow Restriction Training.
BFR training is the brief and intermittent occlusion of veinous and arterial blood flow with the use of a pneumatic tourniquet while performing low-intensity exercise. BFR training is a technique that mimics the effects of high intensity, high load training with low intensity and low load exercises. At SPORT PT, we use Smart Cuffs, which are a certified FDA Listed Class 1 product.
On May 1, 2021 The SPORT PT team participated in a training certification by the industry leading experts on PBFR, Owens Recovery Science. They are a great resource for more information.
In healthy, uninjured bodies, heavy loads and higher intensity exercise are the gold standard to improve strength and muscle mass. Achieving the metabolic effects of high-intensity and load can be an obstacle to recovery in post-injury and post-surgical scenarios, because the joints and tissues may not be ready to respond to such high stimulus.
Blood Flow Restriction addresses this obstacle by using low-intensity training with restricted blood flow to the injured or affected limb. While BFR is still being extensively researched and the exact mechanism of action is still being determined, the working theory is that the restricted blood flow to the muscles imitates the hypoxic (deprived of adequate oxygen) environment within muscles that high intensity, high load exercise creates.
It is currently thought that this replication of that hypoxic state generally achieved only in high intensity exercise, can have systemic hormonal effects within the body. In other words, by restricting blood flow and performing low-load exercise, we are able to achieve the same healing and growing hormonal signals that high intensity strength training provides, thus amplifying the natural healing process and possibly speeding up recovery.
While the idea of tourniquet-style restriction of blood flow has been around for quite some time, it wasn’t as advanced, precise, and safe as it has become today. Previously, blood pressure tourniquets or rubber bands were used to simply occlude blood flow to some unknown degree and then exercise was performed at an intensity that could only be measured subjectively. Because of the lack of specificity and safety, it wasn’t until products like the one we use at SPORT became FDA certified that BFR made its way to the clinical environment. Innovations in pressure regulation and limb occlusion protocols have led to the field of ‘Personalized’ Blood Flow Restriction. Personalizing the Limb Occlusion Pressure (LOP) lets the therapist set metrics and specific protocols that allow for safety and comfort for each patient.
This is done in a specific, individual manner where our Smart Cuff machine will determine what amount of pressure achieves full limb occlusion (blood flow is fully restricted), and then, depending on the chosen working LOP, will adjust to say 80% of that full occlusion value.
For example, if we are working on a lower extremity and have decided on 70% LOP, the machine will pump up the cuff to the point of 100% occlusion, record that number, and then give back the 70% value at which the working sets will be done. So, if full occlusion was at 200 mmHG, the machine will autoregulate the LOP to stay around 140 mmHg during the exercise. As the muscle contracts, the pressure within the muscle naturally rises and the Smart Cuffs pneumatic (air-powered pressure) tourniquet will adjust to maintain the optimal LOP for comfort during the hypoxic state.
Some potential mechanisms for the effects seen with PBFRT are:
- Metabolic Stress
- Release of hormones like Growth Hormone and Insulin Growth Factor
- Cellular Swelling
Here is a link to a meta-analysis of 820 articles on BFR, which concludes that low load exercise combined with BFR produced “an exaggerated response for maximizing muscle strength and hypertrophy.”
If you are interested in doing Personalized BFR Training at SPORT PT give us a call at 970.963.2700, or for existing patients, ask your therapist about BFR.