Longitudinal studies have shown BFR typically outperforms low-intensity training without BFR in various domains pertinent to rehabilitation and fitness practitioners including muscle hypertrophy and strength ( 9), cardiovascular capacity ( 10), time to exhaustion ( 11), functional task performance ( 12) and post-exercise hypoalgesic response ( 13). Commonly, BFR resistance training is performed using loads as low as 20% 1 RM ( 3, 6) whereas BFR aerobic training is usually performed at <50% VO 2max or walking speeds of 4–6 km/h ( 3), although some recent research has successfully applied it post-exercise after bouts of high intensity aerobic exercise ( 7, 8). BFR training involves the use of a compressive cuff that is applied to the proximal-most portion of the limb to partially restrict arterial inflow and occlude venous return ( 3) and has been shown to accelerate metabolic accumulation in both resistance ( 4) and aerobic ( 5) training. Low-load blood flow restriction (BFR) training is an expanding area of research focus in both clinical ( 1) and performance ( 2) settings due to its unique potential benefits in comparison to similar exercise performed without BFR. This manuscript attempts to discuss each of these barriers and provides evidence-based strategies and direction to guide clinical practice and future research. These barriers include determining BFR training pressures, access to appropriate BFR training technologies for relevant demographics based on the current evidence, a comprehensive and systematic approach to medical screening for safe practice and strategies to mitigate excessive perceptual demands of BFR training to foster long-term compliance. However, despite the interest in this area of research, there are likely some perceived barriers that practitioners must overcome to effectively implement this modality into practice. 3Neuromuscular Performance Analysis Laboratory, Department of Physical Therapy, Federal University of Rio Grande do Norte (UFRN), Natal, Brazilīlood flow restriction (BFR) training is increasing in popularity in the fitness and rehabilitation settings due to its role in optimizing muscle mass and strength as well as cardiovascular capacity, function, and a host of other benefits.2Owens Recovery Science, San Antonio, TX, United States.1The Human Performance Mechanic, Lehman College, New York, NY, United States.Nicholas Rolnick 1 * Kyle Kimbrell 2 Mikhail Santos Cerqueira 3 Ben Weatherford 2 Christopher Brandner 4
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