3.11 - BFR

arterial; venous return

apply a tourniquet/BFR to a limb will restrict _________ blood flow and occlude __________

reps; weight

the use of a BFR is high ________ and low _________

true

T/F: BFR can improve bone mineral density

70-85

the ACSM guidelines for hypertrophy is ________% of 1 RM

• 60-70

• 80-100

the ACSM guidelines for strength with untrained people is ________% of 1RM and ________% of 1RM with trained people

20-30

the BFR guidelines for hypertrophy/strength is ________% of 1 RM  

1 (limiting oxygen to the area so we aren’t using our aerobic fibers)

if the BFR is limiting blood flow to the area, it is shutting down type _______ fibers

tension (strain on muscle); metabolic (accumulation of metabolites)

the 2 primary mechanisms for hypertrophy at the cellular level with BFR:

• mechanical ____________

• ____________ stress

1

type 1 or 2 fiber:

slow twitch 

1

type 1 or 2 fiber:

smaller motor units

1

type 1 or 2 fiber:

low intensity, endurance

2

type 1 or 2 fiber:

fast twitch 

2

type 1 or 2 fiber:

larger motor units, hypertrophy

2

type 1 or 2 fiber:

high intensity

mechanical; metabolic 

high-load resistance training creates __________ stress 

low load resistance trainnig PLUS BFR creates ___________ stress

limb occlusion pressure

________________ is the measurement of internal pressure required to occlude arterial blood flow to the limb

radial

if you are calculating the limb occlusion pressure in the upper extremity, what artery are you using the doppler ultrasound on

posterior tibialis or dorsalis pedis 

if you are calculating the limb occlusion pressure in the lower extremity, what artery are you using the doppler ultrasound on

false (you do, pressure is affected by time of day, hydration, medications)

T/F: you don’t need to measure the limb occlusion pressure every day

proximal thigh, inferior to greater trochanter

where would the BFR be placed for lower extremity treatment

above biceps brachii muscle belly, inferior to deltoid tuberosity

where would the BFR be placed for upper extremity treatment

80

the pressure should be _______% of the limb occlusion pressure for lower extremity treatment 

50

the pressure should be _______% of the limb occlusion pressure for upper extremity treatment 

7

the perceived tightness of the cuff should be around a ______ out of 10

• intensity = 20-40% 1 RM

• sets/reps = 75 reps over 4 sets, 30×15×15×15

• rest = 30-60 secs between sets and exercises, 3-5 minutes post-BFR without cuff

• exercises = 3-4 (ex. mix of quad and hamstring exercises)

• time = 20 minutes max

• frequency = 2-3 times/week

exercise prescription for BFR use:

• intensity

• sets/reps

• rest

• exercises

• time

• frequency

20 minutes

what is the max amount of time someone should have the BFR on

• delayed onset muscle soreness

• numbness

• dizziness

• bruising

most common side effects of BFR (4)

• numbness

• pins/needles

• severe discomfort 

• lightheadedness or dizziness 

what are 4 signs that you need to discontinue the use of BFR 

• sickle cell anemia

• factor V leiden (clotting disorder)

• estrogen use

• previous DVT

• liver disease

• immediate post-op period or extended immobility (increased risk of clotting)

what are possible contraindications due to potential increase in adverse outcomes with BFR

• hyperlipidemia

• diabetes

• obesity

• hypertension

• renal disease

what are possible precautions and patients to closely monitor with BFR

>

for strength High-load resistance training ______ Low load BFR

• >

• <

• =

=

for hypertrophy High-load resistance training ______ Low load BFR

• >

• <

• =

true (this is great because ACL post op exercise is a lot of open chain exercises) 

T/F:  BFR causes no detrimental effects on ACL graft laxity 

arthrogenic muscle inhibition

what does AMI stand for

good, promising evidence that BFR with RT can increase VO2 max, isokinetic knee extensor strength, leg muscle mass compared to just RT group

what does the evidence say about using BFR with running training to improve cardiopulmonary function

false (it does!! minimizes the loss of bone density if pt is NWB))

T/F:  passive BFR treatment doesn’t effect bone density 

high load resistance training 

for a healthy patient which is better:

• high load resistance training 

• low load BFR 

low load BFR

for a healthy patient which is better:

• low load resistance training

• low load BFR

• post op 

• if high load isn’t tolerated 

what populations are best for BFR training 

proximal

BFR helps promote benefits (proximal or distal) to the cuff

for better quad activation (AMI - arthrogenic muscle inhibition)

what is the purpose of using the BFR on the lower extremity if you are targeting shutting down AMI