What is the clinical evidence from this study?

Study design: Review. Population: Age-related loss of muscle mass and strength (Sarcopenia). Intervention: Blood flow restriction (BFR) with low-intensity resistance exercise vs. High-intensity resistance exercise or low-intensity exercise alone.

June 20, 2022European Review of Aging and Physical Activity21 citationsOpen Access

Effects of blood flow restriction (BFR) with resistance exercise on musculoskeletal health in older adults: a narrative review

ZLZi Xiang LimNational University of Singapore JGJorming GohAgency for Science, Technology and Research

Key Result

Combining blood flow restriction with low-intensity resistance exercise is a viable and effective method for older adults to maintain musculoskeletal health, eliciting adaptations similar to high-intensity exercise.

Structured PICO

Does low-intensity resistance exercise combined with blood flow restriction improve muscle mass and strength in older adults?

Population

Older adults evaluated for the effects of blood flow restriction combined with resistance exercise on musculoskeletal health.

Intervention

Low-intensity resistance exercise combined with blood flow restriction (BFR)

Comparator

High-intensity resistance exercise, low-intensity resistance exercise alone, or sedentary control

Outcome

Muscle mass and strength (musculoskeletal health)surrogate

Low-intensity resistance exercise combined with blood flow restriction is a viable and effective alternative to high-intensity training for mitigating age-related muscle loss and improving strength in older adults.

Limitations

Small number of studies using BFR on older adults
Most studies recruited a mixed population of older men and women, potentially confounding gender-specific effects like menopause
Within-subject study designs (training one leg with BFR and the other without) may underestimate effects due to crossover
Lack of consensus on optimal occlusion pressure and whether to use full or partial occlusion

Abstract

BACKGROUND: Aging leads to a number of structural and physiological deficits such as loss of muscle mass and strength. Strength training at ~ 70% of 1 repetition max (RM) is recommended to prevent age-related loss of muscle mass and strength. However, most older adults may not be able to perform 70% of 1RM or higher intensity. An alternative exercise training program combining low intensity resistance exercise with blood flow restriction (BFR) can result in similar acute and chronic benefits to skeletal muscles in older adults. MAIN BODY AND SHORT CONCLUSION: The potential mechanisms involved are discussed, and include reactive hyperaemia, metabolic stress, and hypoxia. Key issues and safety with the use of BFR in older adults, especially those with chronic conditions are also discussed. Although there has been no reported evidence to suggest that BFR elevates the risk of clinical complications any more than high intensity exercise, it is recommended for individuals to be medically cleared of any cardiovascular risks, prior to engaging in BFR exercise.

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