Vascular occlusion training

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Blood flow restriction training abbreviated BFR training) or Occlusion Training is an exercise approach whereby resistance exercise or aerobic exercise is performed whilst an Occlusion Cuff is applied to proximal aspect of the muscle[1]. In this novel training method, limb blood flow is restricted via a cuff throughout the contraction cycle and rest period. This results in partial restriction of arterial inflow to muscle, but, most significantly restricts venous outflow from the muscle[2]. Given the light-load nature and strengthening capacity of BFR training, it can provide an effective clinical rehabilitation stimulus without the high levels of joint stress and cardiovascular risk associated with heavy-load training [3]


Many practitioners are using a range of equipment as well as BFR protocols that do not match usage within published literature[4]. The current approaches that focus on applying BFR during exercise consist of automatic pneumatic tourniquet systems or handheld inflatable device called the Occlusion Cuff. Research demonstrating the influence of thigh circumference and cuff width [5] on occlusion pressure has accentuated a likely need for an individualised approach to BFR, particularly with regard to the setting of the restriction pressure. More recently, a technique to calculate and prescribe the occlusive stimulus as a percentage of total limb occlusion pressure is just one example of efforts to account for the above factors and provide an individualised approach to prescribing BFR training that is relatively quick and inexpensive. While the relationship between BFR pressure and the underlying tissue compression during exercise is not yet fully understood, BFR training using 40%–80% of limb occlusion pressure is safe and effective when supervised by experienced practitioners [6] ; therefore, lower pressures may provide less risk without the need for higher pressure.


Historically, heavy exercise loads of approximately 70% of an individual's one repetition maximum (1RM) have been deemed necessary to elicit muscle hypertrophy and strength gains [7]. In recent years, research has demonstrated that augmentation of low-load resistance training with blood flow restriction (LL-BFR) to the active musculature can produce significant hypertrophy and strength gains [8][9], using loads as low as 30% 1RM [10]. BFR training has been found to yield hypertrophy responses comparable to that observed with heavy-load resistance training [11].


When using belts and lifting straps for tourniquet, the amount of pressure on the vasculature cannot be controlled and there are reports of rhabdomyolysis cases due to VOT.[12] Sato himself risked his life in 1967 after uncontrolled sessions of VOT, leading him to focus more on control and adjustment of the pressure applied on the vasculature.

See also[edit]


  1. ^ Scott, Brendan R.; Loenneke, Jeremy P.; Slattery, Katie M.; Dascombe, Ben J. (March 2015). "Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development". Sports Medicine (Auckland, N.Z.). 45 (3): 313–325. doi:10.1007/s40279-014-0288-1. ISSN 1179-2035. PMID 25430600.
  2. ^ Patterson, Stephen D.; Hughes, Luke; Head, Paul; Warmington, Stuart; Brandner, Christopher (2017-06-22). "Blood flow restriction training: a novel approach to augment clinical rehabilitation: how to do it". Br J Sports Med. 51 (23): bjsports–2017–097738. doi:10.1136/bjsports-2017-097738. ISSN 0306-3674. PMID 28642225.
  3. ^ Hughes, Luke; Paton, Bruce; Rosenblatt, Ben; Gissane, Conor; Patterson, Stephen David (2017-07-01). "Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis". Br J Sports Med. 51 (13): 1003–1011. doi:10.1136/bjsports-2016-097071. ISSN 0306-3674. PMID 28259850.
  4. ^ Patterson, Stephen D.; Brandner, Christopher R. (February 2017). "The role of blood flow restriction training for applied practitioners: A questionnaire-based survey". Journal of Sports Sciences. 36 (2): 123–130. doi:10.1080/02640414.2017.1284341. ISSN 0264-0414. PMID 28143359.
  5. ^ Loenneke, Jeremy P.; Fahs, Christopher A.; Rossow, Lindy M.; Sherk, Vanessa D.; Thiebaud, Robert S.; Abe, Takashi; Bemben, Debra A.; Bemben, Michael G. (2011-12-06). "Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise". European Journal of Applied Physiology. 112 (8): 2903–2912. doi:10.1007/s00421-011-2266-8. ISSN 1439-6319. PMC 4133131. PMID 22143843.
  6. ^ Soligon, SD; Lixandrão, ME; Biazon, TMPC; Angleri, V; Roschel, H; Libardi, CA (September 2018). "Lower occlusion pressure during resistance exercise with blood-flow restriction promotes lower pain and perception of exercise compared to higher occlusion pressure when the total training volume is equalized". Physiology International. 105 (3): 276–284. doi:10.1556/2060.105.2018.3.18. ISSN 2498-602X. PMID 30269562.
  7. ^ Garber, Carol Ewing; Blissmer, Bryan; Deschenes, Michael R.; Franklin, Barry A.; Lamonte, Michael J.; Lee, I-Min; Nieman, David C.; Swain, David P. (July 2011). "Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory, Musculoskeletal, and Neuromotor Fitness in Apparently Healthy Adults". Medicine & Science in Sports & Exercise. 43 (7): 1334–1359. doi:10.1249/mss.0b013e318213fefb. ISSN 0195-9131. PMID 21694556.
  8. ^ BURGOMASTER, KIRSTEN A.; MOORE, DAN R.; SCHOFIELD, LEE M.; PHILLIPS, STUART M.; SALE, DIGBY G.; GIBALA, MARTIN J. (July 2003). "Resistance Training with Vascular Occlusion: Metabolic Adaptations in Human Muscle". Medicine & Science in Sports & Exercise. 35 (7): 1203–1208. doi:10.1249/01.mss.0000074458.71025.71. ISSN 0195-9131. PMID 12840643.
  9. ^ Loenneke, Jeremy P.; Kim, Daeyeol; Fahs, Christopher A.; Thiebaud, Robert S.; Abe, Takashi; Larson, Rebecca D.; Bemben, Debra A.; Bemben, Michael G. (2015-04-20). "Effects of exercise with and without different degrees of blood flow restriction on torque and muscle activation". Muscle & Nerve. 51 (5): 713–721. doi:10.1002/mus.24448. ISSN 0148-639X. PMID 25187395.
  10. ^ Takarada, Yudai; Tsuruta, Tomomi; Ishii, Naokata (2004). "Cooperative Effects of Exercise and Occlusive Stimuli on Muscular Function in Low-Intensity Resistance Exercise with Moderate Vascular Occlusion". The Japanese Journal of Physiology. 54 (6): 585–592. doi:10.2170/jjphysiol.54.585. ISSN 0021-521X.
  11. ^ Loenneke, Jeremy P.; Wilson, Jacob M.; Marín, Pedro J.; Zourdos, Michael C.; Bemben, Michael G. (2011-09-16). "Low intensity blood flow restriction training: a meta-analysis". European Journal of Applied Physiology. 112 (5): 1849–1859. doi:10.1007/s00421-011-2167-x. ISSN 1439-6319. PMID 21922259.
  12. ^ Big Ass Mass: Occlusion Training, Bryan Haycock, FLEX