Chua Man Tong, Sim Alexiaa, Burns Stephen Francis
Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore, 637636, Singapore.
Sports Med Open. 2022 Sep 30;8(1):122. doi: 10.1186/s40798-022-00506-y.
The implementation of blood flow restriction (BFR) during exercise is becoming an increasingly useful adjunct method in both athletic and rehabilitative settings. Advantages in pairing BFR with training can be observed in two scenarios: (1) training at lower absolute intensities (e.g. walking) elicits adaptations akin to high-intensity sessions (e.g. running intervals); (2) when performing exercise at moderate to high intensities, higher physiological stimulus may be attained, leading to larger improvements in aerobic, anaerobic, and muscular parameters. The former has been well documented in recent systematic reviews, but consensus on BFR (concomitant or post-exercise) combined with high-intensity interval training (HIIT) protocols is not well established. Therefore, this systematic review evaluates the acute and chronic effects of BFR + HIIT.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify relevant studies. A systematic search on 1 February 2022, was conducted on four key databases: ScienceDirect, PubMed, Scopus and SPORTDiscus. Quality of each individual study was assessed using the Physiotherapy Evidence Database (PEDro) scale. Extraction of data from included studies was conducted using an adapted version of the 'Population, Intervention, Comparison, Outcome' (PICO) framework.
A total of 208 articles were identified, 18 of which met inclusion criteria. Of the 18 BFR + HIIT studies (244 subjects), 1 reported both acute and chronic effects, 5 examined acute responses and 12 investigated chronic effects. Acutely, BFR challenges the metabolic processes (vascular and oxygenation responses) during high-intensity repeated sprint exercise-which accelerates central and peripheral neuromuscular fatigue mechanisms resulting in performance impairments. Analysis of the literature exploring the chronic effects of BFR + HIIT suggests that BFR does provide an additive physiological training stimulus to HIIT protocols, especially for measured aerobic, muscular, and, to some extent, anaerobic parameters.
Presently, it appears that the addition of BFR into HIIT enhances physiological improvements in aerobic, muscular, and, to some extent, anaerobic performance. However due to large variability in permutations of BFR + HIIT methodologies, it is necessary for future research to explore and recommend standardised BFR guidelines for each HIIT exercise type.
运动期间实施血流限制（BFR）在运动和康复环境中都正成为一种越来越有用的辅助方法。在两种情况下可以观察到将BFR与训练相结合的优势：（1）在较低绝对强度下训练（如步行）能引发类似于高强度训练（如跑步间歇）的适应性变化；（2）当进行中等至高强度运动时，可获得更高的生理刺激，从而在有氧、无氧和肌肉参数方面带来更大改善。前者在最近的系统评价中有充分记录，但关于BFR（运动中或运动后）与高强度间歇训练（HIIT）方案相结合的共识尚未完全确立。因此，本系统评价评估了BFR + HIIT的急性和慢性影响。
采用系统评价和Meta分析的首选报告项目（PRISMA）指南来识别相关研究。于2022年2月1日在四个关键数据库进行了系统检索：ScienceDirect、PubMed、Scopus和SPORTDiscus。使用物理治疗证据数据库（PEDro）量表评估每项独立研究的质量。从纳入研究中提取数据时使用了“人群、干预措施、对照、结局”（PICO）框架的改编版本。
共识别出208篇文章，其中18篇符合纳入标准。在这18项BFR + HIIT研究（244名受试者）中，1项报告了急性和慢性影响，5项研究了急性反应，12项研究了慢性影响。急性情况下，BFR在高强度重复冲刺运动中挑战代谢过程（血管和氧合反应），这会加速中枢和外周神经肌肉疲劳机制，导致运动表现受损。对探索BFR + HIIT慢性影响的文献分析表明，BFR确实为HIIT方案提供了额外的生理训练刺激，特别是对于所测量的有氧、肌肉以及在一定程度上的无氧参数。
目前，在HIIT中加入BFR似乎能增强有氧、肌肉以及在一定程度上无氧运动表现的生理改善。然而，由于BFR + HIIT方法的排列组合差异很大，未来的研究有必要探索并推荐针对每种HIIT运动类型的标准化BFR指南。
