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1. Patients or post-operative patients, high load and high intensity exercises may not be clinically proper. Blood Circulation Constraint (BFR) training is a strategy that combines low intensity exercise with blood flow occlusion that produces similar results to high intensity training. It has been used in the fitness center setting for some time but it is getting appeal in scientific settings. Blood Flow Limitation (BFR) Training [edit modify source] BFR training was at first developed in the 1960's in Japan and called KAATSU training. It can be applied to either the upper or lower limb. The cuff is then pumped up to a particular pressure with the objective of obtaining partial arterial and total venous occlusion. The patient is then asked to perform resistance exercises at a low intensity of 20-30% of 1 repeating max (1RM), with high repetitions per set (15-30) and short rest intervals between sets (30 seconds) Comprehending the Physiology of Muscle Hypertrophy. [edit modify source] Muscle hypertrophy is the increase in size of the muscle in addition to an increase of the protein content within the fibers. Muscle stress and metabolic tension are the two main elements responsible for muscle hypertrophy. Mechanical Stress & Metabolic Tension [edit modify source] When a muscle is positioned under mechanical tension, the concentration of anabolic hormone levels increase. The activation of myogenic stem cells and the raised anabolic hormonal agents lead to protein metabolic process and as such muscle hypertrophy can take place. Growth hormonal agent itself does not straight trigger muscle hypertrophy but it helps muscle recovery and thus possibly helps with the muscle enhancing process. The build-up of lactate and hydrogen ions (eg in hypoxic training) more increases the release of development hormonal agent. Myostatin controls and prevents cell development in muscle tissue. It requires to be basically shut down for muscle hypertrophy to occur. Resistance training leads to the compression of capillary within the muscles being trained. This causes an hypoxic environment due to a decrease in oxygen shipment to the muscle. When there is blood pooling and an accumulation of metabolites cell swelling occurs. This swelling within the cells causes an anabolic response and results in muscle hypertrophy.

2. The cuff is put proximally to the muscle being workout and low intensity exercises can then be performed. Because the outflow of blood is restricted utilizing the cuff capillary blood that has a low oxygen content collects and there is an increase in protons and lactic acid. The exact same physiological adjustments to the muscle (eg release of hormones, hypoxia and cell swelling) will occur during the BFR training and low intensity exercise as would accompany high intensity workout. ( 1) Low strength BFR (LI-BFR) results in an increase in the water content of the muscle cells (cell swelling). It likewise accelerates the recruitment of fast-twitch muscle fibres. It is also hypothesized that once the cuff is eliminated a hyperemia (excess of blood in the capillary) will form and this will trigger further cell swelling. These increases resembled gains gotten as a result of high-intensity workout without BFR A study comparing (1) high strength, (2) low strength, (3) low and high intensity with BFR and (4) low intensity with BFR. While all 4 workout regimes produced boosts in torque, muscle activations and muscle endurance over a 6 week period - the high intensity (group 1) and BFR (groups 3 and 4) produced the biggest result size and were similar to each other.