Advertisement

Central cardiovascular hemodynamic response to unilateral handgrip exercise with blood flow restriction

  • Daniel P. CredeurEmail author
  • Raymond Jones
  • Daphney Stanford
  • Lee Stoner
  • Stephanie McCoy
  • Matthew Jessee
Original Article
  • 68 Downloads

Abstract

Aim

Exercise training with blood flow restriction (BFR) increases muscle size and strength. However, there is limited investigation into the effects of BFR on cardiovascular health, particularly central hemodynamic load.

Purpose

To determine the effects of BFR exercise on central hemodynamic load (heart rate—HR, central pressures, arterial wave reflection, and aortic stiffness).

Methods

Fifteen males (age = 25 ± 2 years; BMI = 27 ± 2 kg/m2, handgrip max voluntary contraction-MVC = 50 ± 2 kg) underwent 5-min bouts (counter-balanced, 10 min rest between) of rhythmic unilateral handgrip (1 s squeeze, 2 s relax) performed with a moderate-load (60% MVC) with and without BFR (i.e., 71 ± 5% arterial inflow flow reduction, assessed via Doppler ultrasound), and also with a low-load (40% MVC) with BFR. Outcomes included HR, central mean arterial pressure (cMAP), arterial wave reflection (augmentation index, AIx; wave reflection magnitude, RM%), aortic arterial stiffness (pulse wave velocity, aPWV), and peripheral (vastus lateralis) microcirculatory response (tissue saturation index, TSI%).

Results

HR increased above baseline and time control for all handgrip bouts, but was similar between the moderate load with and without BFR conditions (moderate-load with BFR =  + 9 ± 2; moderate-load without BFR =  + 8 ± 2 bpm, p < 0.001). A similar finding was noted for central pressure (e.g., moderate load with BFR, cMAP =  + 14 ± 1 mmHg, p < 0.001). No change occurred for RM% or AIx (p > 0.05) for any testing stage. TSI% increased during the moderate-load conditions (p = 0.01), and aPWV increased above baseline following moderate-load handgrip with BFR only (p = 0.012).

Conclusions

Combined with BFR, moderate load handgrip training with BFR does not significantly augment central hemodynamic load during handgrip exercise in young healthy men.

Keywords

Vascular stiffness Kaatsu Autonomic function Blood flow Pulse wave reflection 

Abbreviations

Aix

Augmentation Index

AP

Augmentation pressure

aPWV

Aortic pulse wave velocity

BFR

Blood flow restriction exercise

BP

Blood pressure

cMAP

Central mean arterial pressure

H+

Hydrogen ions

HF

High-frequency component

HR

Heart rate

HRV

Heart rate variability

L1

Distance between sternal notch and carotid pulse site

L2

Distance between sternal notch and proximal edge of thigh cuff

LF

Low-frequency component

LF/HF

Low-frequency-to-high-frequency component ratio

MHz

Mega-hertz

MVC

Maximal voluntary contraction

NIRS

Near-infrared spectroscopy

Pb

Backward pressure component

Pf

Forward pressure component

PP

Pulse pressure

RM%

Reflection magnitude

RMSSD

Root mean square of standard deviation of R–R intervals

RPP

Rate pressure product

SDNN

Standard deviation of R–R intervals

TSI%

Tissue Saturation Index

Vmean

Mean blood velocity

Notes

Acknowledgements

The authors would like to thank the participants for their time and dedication towards the study. The authors would also like to thank the students (graduate and undergraduate) from the School of Kinesiology and Nutrition at the University of Southern Mississippi for their support and assistance throughout the various stages of this project.

Author contributions

DC, LS, and SM conceived, and designed research; DC, RJ, and SM conducted experiments; DC, RJ, DS, LS, and MJ analyzed data; DC and RJ drafted the manuscript. All authors read, edited, and approved the final manuscript for submission.

Compliance with ethical standards

Conflict of interest

There are no conflicts of interest to report for this study.

References

  1. Abe T, Kearns CF, Sato Y (2006) Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol 100:1460–1466CrossRefPubMedGoogle Scholar
  2. Alam M, Smirk FH (1937) Observations in man upon a blood pressure raising reflex arising from the voluntary muscles. J Physiol 89:372–383CrossRefPubMedPubMedCentralGoogle Scholar
  3. Barstow TJ (2019) Understanding near infrared spectroscopy (NIRS) and its application to skeletal muscle research. J Appl Physiol 126:1360–1376CrossRefPubMedGoogle Scholar
  4. Butlin M, Qasem A, Avolio AP (2012) Estimation of central aortic pressure waveform features derived from the brachial cuff volume displacement waveform. Conf Proc IEEE Eng Med Biol Soc 2012:2591–2594PubMedGoogle Scholar
  5. Camm AJ et al (1996) Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation 93:1043–1065CrossRefGoogle Scholar
  6. Credeur DP, Hollis BC, Welsch MA (2010) Effects of handgrip training with venous restriction on brachial artery vasodilation. Med Sci Sports Exer 42:1296–1302CrossRefGoogle Scholar
  7. Credeur DP et al (2014) Characterizing rapid onset vasodilation to single muscle contractions in the human leg. J Appl Physiol 118:455–464CrossRefPubMedPubMedCentralGoogle Scholar
  8. Dankel SJ, Jessee MB, Abe T, Loenneke JP (2016) The effects of blood flow restriction on upper-body musculature located distal and proximal to applied pressure. Sports Med 46:23–33CrossRefPubMedGoogle Scholar
  9. Delaney EP, Greaney JL, Edwards DG, Rose WC, Fadel PJ, Farquhar WB (2010) Exaggerated sympathetic and pressor responses to handgrip exercise in older hypertensive humans: role of the muscle metaboreflex. Am J Physiol Heart Circ Physiol 299:H1318–1327CrossRefPubMedPubMedCentralGoogle Scholar
  10. Domingos E, Polito MD (2018) Blood pressure response between resistance exercise with and without blood flow restriction: A systematic review and meta-analysis. Life Sci 209:122–131CrossRefPubMedGoogle Scholar
  11. Dursteine JL, Moore GM (2003) ACSM's exercise management for persons with chronic diseases and disabilities, 2nd edn. Human kineticsGoogle Scholar
  12. Fadel PJ, Keller DM, Watanabe H, Raven PB, Thomas GD (2004) Noninvasive assessment of sympathetic vasoconstriction in human and rodent skeletal muscle using near-infrared spectroscopy and Doppler ultrasound. J Appl Physiol 96:1323–1330CrossRefPubMedGoogle Scholar
  13. Gebber GL, Zhong S, Lewis C, Barman SM (2000) Defenselike patterns of spinal sympathetic outflow involving the 10-Hz and cardiac-related rhythms. Am J Physiol Regul Integr Comp Physiol 278:R1616–1626CrossRefPubMedGoogle Scholar
  14. Gorgey AS, Timmons MK, Dolbow DR, Bengel J, Fugate-Laus KC, Michener LA, Gater DR (2016) Electrical stimulation and blood flow restriction increase wrist extensor cross-sectional area and flow meditated dilatation following spinal cord injury. Eur J Appl Physiol 116:1231–1244CrossRefPubMedGoogle Scholar
  15. Holwerda SW, Restaino RM, Manrique C, Lastra G, Fisher JP, Fadel PJ (2016) Augmented pressor and sympathetic responses to skeletal muscle metaboreflex activation in type 2 diabetes patients. Am J Physiol Heart Circ Physiol 310:H300–309CrossRefPubMedGoogle Scholar
  16. Horiuchi M, Fadel PJ, Ogoh S (2014) Differential effect of sympathetic activation on tissue oxygenation in gastrocnemius and soleus muscles during exercise in humans. Exp Physiol 99:348–358CrossRefPubMedGoogle Scholar
  17. Hunt JE, Walton LA, Ferguson RA (2012) Brachial artery modifications to blood flow-restricted handgrip training and detraining. J Appl Physiol 112:956–961CrossRefPubMedGoogle Scholar
  18. Kaur J et al (2015) Muscle metaboreflex activation during dynamic exercise vasoconstricts ischemic active skeletal muscle. Am J Physiol Heart Circ Physiol 309:H2145–2151CrossRefPubMedPubMedCentralGoogle Scholar
  19. American College of Sports Medicine (2018) ACSM's guidelines for exercise testing and prescription, 10th edn. Wolters Kluwer, Alphen aan den RijnGoogle Scholar
  20. Loenneke JP, Wilson GJ, Wilson JM (2010) A mechanistic approach to blood flow occlusion. Int J Sports Med 31:1–4CrossRefPubMedGoogle Scholar
  21. Lucero AA et al (2018) Reliability of muscle blood flow and oxygen consumption response from exercise using near-infrared spectroscopy. Exp Physiol 103:90–100CrossRefPubMedGoogle Scholar
  22. Morrison SF (2001) Differential control of sympathetic outflow. Am J Physiol Regul Integr Comp Physiol 281:R683–698CrossRefPubMedGoogle Scholar
  23. Morrison SF (2001) Differential regulation of brown adipose and splanchnic sympathetic outflows in rat: roles of raphe and rostral ventrolateral medulla neurons. Clin Exp Pharmacol Physiol 28:138–143CrossRefPubMedGoogle Scholar
  24. Morrison SF (2001) Differential regulation of sympathetic outflows to vasoconstrictor and thermoregulatory effectors. Ann N Y Acad Sci 940:286–298CrossRefPubMedGoogle Scholar
  25. Mouser JG, Dankel SJ, Jessee MB, Mattocks KT, Buckner SL, Counts BR, Loenneke JP (2017) A tale of three cuffs: the hemodynamics of blood flow restriction. Eur J Appl Physiol 117:1493–1499CrossRefPubMedGoogle Scholar
  26. Qasem A, Avolio A (2008) Determination of aortic pulse wave velocity from waveform decomposition of the central aortic pressure pulse. Hypertension 51:188–195CrossRefPubMedGoogle Scholar
  27. Smith SA, Mitchell JH, Garry MG (2006) The mammalian exercise pressor reflex in health and disease. Exp Physiol 91:89–102CrossRefPubMedGoogle Scholar
  28. Smith SA, Leal AK, Young CN, Fadel PJ (2010) Neural mechanisms of cardiovascular control during exercise in health and disease. Recent advances in cardiovascular research: from sleep to exercise. Transworld research network, pp 179–209. http://www.ressign.com/UserBookDetail.aspx?bkid=1029&catid=236#
  29. Spranger MD, Krishnan AC, Levy PD, O'Leary DS, Smith SA (2015) Blood flow restriction training and the exercise pressor reflex: a call for concern. Am J Physiol Heart Circ Physiol 309:H1440–1452CrossRefPubMedGoogle Scholar
  30. Sprick JD, Rickards CA (2017) Combining remote ischemic preconditioning and aerobic exercise: a novel adaptation of blood flow restriction exercise. Am J Physiol Regul Integr Comp Physiol 313:R497–R506CrossRefPubMedPubMedCentralGoogle Scholar
  31. Sugaya M, Yasuda T, Suga T, Okita K, Abe T (2011) Change in intramuscular inorganic phosphate during multiple sets of blood flow-restricted low-intensity exercise. Clin Physiol Funct Imaging 31:411–413CrossRefPubMedGoogle Scholar
  32. Thavasothy M, Broadhead M, Elwell C, Peters M, Smith M (2002) A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 Near-Infrared Spectrophotometers. Anaesthesia 57:999–1006CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Kinesiology and NutritionUniversity of Southern MississippiHattiesburgUSA
  2. 2.Department of Exercise and Sports ScienceUniversity of North CarolinaChapel HillUSA

Personalised recommendations