Blood Flow Restriction

The application of a specialized tourniquet system to a proximal arm or leg, which is inflated, to a personalized and specific pressure to reduce blood flow to an exercising extremity. The application is brief and intermittent, typically about 8 minutes per exercise, but can last up to 40 minutes based on the specific protocol. With Personalized Blood Flow Restriction (PBFR) you can create significant strength and hypertrophy gains with loads as low as 20% 1RM.

The exact mechanism behind the positive results seen with PBFR is still being extensively researched. Theories range from a significant build up of metabolites by anaerobic metabolism, a systemic anabolic response and cellular swelling. It is most likely a combination of multiple factors. It does appear that muscle protein synthesis plays a primary role as this has been consistently demonstrated in the literature.

There is a substantial amount of literature that has studied the effects of PBFR. In fact, a recent meta-analysis found a total of 820 articles pertaining to PBFR. The authors of the review concluded “Importantly, research suggests that low load resistance exercise (20–30% 1 RM) and low load aerobic exercise (<70 m/min walk training), which would not be expected to cause considerable increases in muscular quantity or quality under normal circumstances, when combined with PBFR produced an exaggerated response for maximizing muscle strength and hypertrophy.” (http://www.jsams.org/article/S1440-2440(15)00182-6/abstract?cc=y=)

PBFR consistently demonstrates greater results compared to work matched controls exercising without PBFR. The positive results have been seen in patients after injury, in the elderly, and in athletes. It has also been applied extensively in a military rehabilitation setting on severely compromised patients. (http://www.defense.gov/news/newsarticle.aspx?id=123685)

PBFR has consistently demonstrated to be a safe modality in the literature. It has been performed on thousands of subjects in the peer-reviewed literature with little to no side effects.

Physical therapists (PTs) have an existing firm foundation in anatomy, physiology, therapeutic exercise, and the cardiorespiratory system, as well as clinical reasoning, which are the components of the safe application of blood flow restriction training (BFRT). Physical therapist education provides PTs with the requisite knowledge (muscular and vascular anatomy, and physiology and exercise physiology), as well as skills (therapeutic exercise prescription, monitoring of physiological vital signs and blood flow) to perform and monitor this type of therapeutic exercise. BFRT is part of the professional scope of practice for physical therapist. (https://www.apta.org/PatientCare/BloodFlowRestrictionTraining/)