Blood flow restriction therapy uses elastic bands or tourniquets to restrict venous blood flow from leaving exercised muscles during low-intensity exercises, causing the muscles to be exposed to metabolic stress similar to high-intensity training. A case study found that using blood flow restriction during low-intensity bicep curls and triceps extensions led to greater increases in blood lactate, heart rate, and perceived exertion compared to the same exercises without restriction. While blood flow restriction allows for muscle gains with lower exercise loads, it can increase risks of delayed muscle soreness, thrombosis, and elevated blood pressure.

1. Blood Flow
Restriction Therapy
And it’s effects on muscular strength
By Cody Small

2. 2
Overview
Make up of a muscle and steps for
contractions
Muscle Hypertrophy and how it occurs
Why muscle strength is important
What Is Blood Flow restriction therapy?
Case Study
How can it benefit our patients
What are some complications with BFR
exercise

3. 3
Components of a Muscle

4. 4
Muscle Contractions

5. 5
Muscle Hypertrophy
Muscle grows along lines of stress
Exercise increases muscle size and cross
sectional area
• Eccentric and Concentric contractions at about
80-90% 1 RM(2-6 reps)
• Low intensity: 20-30% with 20-30 reps
Progressive overload
Myofibril hypertrophy  increases
strength

6. 6
Why is muscle Strength
important?
Provide Stability and support to our body
Allows patients to perform ADL
Overall increase in health
Injury Prevention/disease
Increased Endurance

7. 7
What is Blood Flow restriction?
Blood flow restriction uses a
tourniquet/occlusion bands to restrict
venous blood flow without restricting
arterial blood flow.
Commonly used in Surgery and Strength
training
So how does this work?

8. 8
Mechanism of BFR therapy
Occlusion of venous blood flow without
affecting arterial blood flow
Decrease 02  recruits type 2 fibers
• Leads to increase in production of muscle
metabolites; GH, IGF1, satellite
Low oxygen supply leads to anaerobic
energy production  build up of lactic
acid  protein synthesis

9. 9
Case Study: Title

10. 10
Case Study: Objective
Achieve muscle hypertrophy with the use
of elastic bands instead of high intensity
exercise in conjunction with BFR

11. 11
Case Study: Methods
Subjects: 9 healthy men, 23-41 years of
age
Subjects were required to perform
bilateral triceps extension and bicep
flexion with and without a BFR cuff 
separated 1 week apart randomly
30 reps followed by 3 sets of 15 reps

12. 12
Case Study: Methods continued
Cuff restriction(170-260 mmhg) was
determined by rate of perceived exertion
during the exercises that were to be
conducted in the study
EMG recording was done to look at
muscle activity for each exercise treatment
Heart Rate measurements were taken
baseline, Post and 15 minute post exercise

13. 13
Case Study: Methods continued
Blood lactate levels were measured prior to
treatment, Post treatment, and 15 minutes post
treatment
Exercise intensity was determined with EMG
recordings with free weights for the same
exercises(10%, 20%, 30%, 40% and 50%)
RPE was measured with the Borg scale at the
end of each set

14. 14
Case Study: Results

15. 15
Case Study: Results

16. 16
Case Study: Results
At baseline Blood lactate levels were no
different between the BFR and the control
group(1.0 +/- . 01 vs 1.0 +/- .2 mmol/L).
Blood lactate Post exercise was higher in
the BFR group(3.6 vs 2.1 mmol/L) and
remained elevated(1.8 vs 1.2mml)

17. 17
Case Study: Results

18. 18
Case Study: Results
No measurable difference at baseline for
heart rate(67.4 +/-9.6 vs 66.0 +/- 9.2)
After exercises Heart rate was higher in
the BFR group(109+/- 22 a min vs 90 +/-
15 a min
RPE was greater in the BFR group(17.4
+/- 1.7 vs 12.9 +/- 1.6)

19. 19
How it Relates to Physical
Therapy
BFR allows you to reduce the load on a
joint while still increasing strength gains
No longer have to do Max Reps to see
strength gains!
Can be used for patient’s, like Total knee
replacement patient’s

20. 20
Down sides to Blood flow
restriction Therapy
Delayed onset muscle soreness
Can only be used for the extremities
Cuff can be applied to tightly
Increase in HR and BP at same intensity without
BFR
Possibility of Thrombosis
• Recent study found that there is an increase in tPA

21. 21
References
Hackney, K., Everett, M., Scott, J., & Ploutz-Snyder, L. (2012). Blood flow-
restricted exercise in space. Extreme Physiology & Medicine, 12-12.
Retrieved December 15, 2014, from
http://www.extremephysiolmed.com/content/1/1/12#refs
Yasuda, T., Fukuda, T., Fukumura, K., Lida, H., Imuta, H., Sato, Y., ...
Nakajima, T. (2012). Effects of Low intensity, elastic band resistance
exercise combined with blow flow restriction on muscle activation.
Scandinavian Journal of Medicine and Science in Sports, 55-61.