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Development Team Member
Posts: 168
Great info presented. Thank you for this webinar!

Comment: This does continue to look better each time I see info regarding BFR method and blocks.

I would hesitate to leverage this stimulation with clients presenting with centrally-driven supply or delivery restraints.

Any thoughts ?


Development Team Member
Posts: 369
Thanks for the interesting webinar.

I have three questions:
1. Training at lower intensities was mentioned as the main draw card of this BFR training. My question is do the benefits of training at lower intensities still apply with the cuffs on in BFR. So for example, perceived exertion, number of repetitions that can be completed, recovery would all be more "favourable"  in low intensity compared to high intensity. However is this still true for low intensity with cuff on vs high intensity?

2. Related to the above, what other physiological changes do you observe when doing low intensity vs low intensity with the cuffs - for example how do cardiac output (heart rate, stroke volume), respiration etc change with the cuffs off vs on?

3. From the research (or anecdotally), is there anything to suggest that this type of training works better on candidates that have strong delivery systems but weaker utilisation (i.e. effectively forcing utilisation efficiency improvements through restricting delivery).


Development Team Member
Posts: 1,501
Here  are  some feedback  for  how we use  BFR   since  years  and  how we  use NIRS  to control. We use  due to price as well juts the mechanical  cuff  "straps"  we sue them as well because we believe  the control is done  over  NIRS feedback  much better than when using  cuff pressure over  pneumatic   ideas.
 Each person has some difference  and  200 mmHg  may  not create the same restriction in each persons  so using NIRS   may be a better way.
 The  feedback  I use is tHb  reaction.
 remember our   occlusion feedback on biceps  contraction we showed many times.

 tHb  drop  indicates a   compression outflow , than it turns into a  increase in tHb  as a sign of  inflow   okay,  but restricted outflow ( venous occlusion)  followed  by a  stable tHb if  we reach arterial occlusion, . Feedback is than  when we release it as an occlusion outflow. Now  I think this  way  I have  a nicer  control , than asking the patent  on how he  feels on the suggested scale  0 -  10.
 Now depending  how  you pull the  strap you will  see a difference in the speed of  tHb increase. The  speed on the increase as well depends  ,whether you  do a  strength or an endurance  BFR  exercise. CO  has  a lot  to  do. So the same   compression   applied in a  endurance  load  will  speed up increase in tHB  much faster .
So as  so often  we than need a combination of tHB  feedback  (   feedback on  pooling  )  combined  with eth  feedback  on " hypoxia " or speed  of   SmO2  drop.
 Now this is  opposite.  In endurance BFR  you will see a  rapid  increase in tHB  by the same  raping pressure, compared to a  leg workout, but  you see in the leg  workout a  faster  drop  in SmO  compared  to te   endurance    workout.
 Why ?
 Therefor  e do not use  any of the  ideas in the literature  at all.
 Why  30  reps  or  2  x  15  and  why  30 - 90 seconds  rest.
 little  to no  feedback   as just using a timer.
 I use  direct individual feedback  from each client.
 So  you have different options.
Now keep in mind. tHB  reaction  when doing  a  wrapping occlusion  compared to a  natural  muscle contraction occlusion  has a small difference in the tHB  reaction. In the  artificial  BFP  idea  with a   wrapping you will miss one  tHB  reaction.
Which  one. ?
Now   what you can do is . Follow  the   cook book   ideas of  30  and  30 / 60 / 90 seconds  rest.  and  use the recommended  %   of  max  ( peak  VO2 ) or  %  of 1  max  rep . and look  carefully how  SmO2  reacts. You will se some interesting SmO2 tends  . They  depend  very strong on the % of loads  you use  for strength and the  %  of  VO2 peak  you use for walking.

Than  for Spiro users   do a walking part  with  hypercapnia  hypoxia  and  look how SmO2  reacts .
  Remember   the "cook book "
  To    possibly stimulate  utilization  you  restrict  delivery  !.  Is  BFR  ne of this  options ?
To try to  stimulate  delivery you restrict  utilization.
  Summary .
 A super great   presentation  which   for me highlights  the interesting  future , where we  may be able to use physiological feedbacks  li we  do    and can convince  traditional thoughts of using numbers  and time for    loads  . It is the old  question  hy  30  reps  wy 60 min rest.  This is an  organisational  convenient idea  easy to control but what does it has in common  with individual physiological reactions.
 BFR  and MOXY  / NIRS is  an incredible   interesting combination  for rehab  at least as I  do  and  NIRS  live feedback  helps  me to keep an individual control on  what  am doing.  and  the client  an see t live  as well.
Thanks  for this   great   webinar.  Practical hint.
 I use th e idea  for  post ops  TKR  as well as   THR  and   ACL  when we are not able to load  high intensities is anyway  but we like to   get  an early start on  regaining  strength or maintaining  strenght.

Development Team Member
Posts: 1
I just wanted to share a BFR training session on an 8week protocol that I am doing. It consists of 5 sets with 5 reps (High Bar Back Squats) with 70% of 1RM. It is a protocol of cook et. al (2014) with rugby players. 

What are your thoughts? I think we could use a little more occlusion so SmO2 will stay on a little lower level. 

With the "Air Squat BFR Test" we just tested if we have not too much arterial occlusion an SmO2 is recovering.


Development Team Member
Posts: 168
Interesting work. Thanks for sharing. 

I wonder if you could share a little more: 

- I don't understand the purpose of your BFR Air Squat Test. It's not described in the 20 player study. Can you explain ? 

- It looks like you followed the described protocol by releasing the cuff between loads. Can you confirm ? 

- Did you use an inflatable cuff or something different ? Please describe ? 

- What exercises did you do, starting from set 1 - 5. The abstract describes Squat, Bench and weighted Pull-ups.

- How close did you land to 70% of 1 RM ?

This loading and cuff tension is quite a bit higher than many of the protocols that I have read, also uses compound / main lifts over accessory limb work. You must be starting from a state of very good strength and conditioning, otherwise I (with my limited experience) may expect a challenge to get the tHb pooling as you did on the odd # sets. 

- What do you think happened during set 2 & 4 ?  Different exercise or same ?


Development Team Member
Posts: 1,501
Need csv  from  Peripedal  to  look at  some  reactions on HHb  and O2Hb  as it is  easier to explain. The second  part  in cases like to  this is  that we need  not the reps  but the actual time when you started  and ended.
 Reason. Look at the 200 m sprints  we discussed. There is something like  seen  w0krout  ( 5  resp ) but there is often a physiological  time  where you stimulate. Example CO2  hypercapnic  workouts  can be  finished   as a  workout  after  30 seconds  but keep    desaturation  going  perhaps  another 15 seconds depending how you plan it.

Development Team Member
Posts: 168
Here's another BFR study protocol using varied methods.

Looks like they apply the venous occlusion immediately following a work set / interval, rather than dropping the load too low and performing under restriction... Interesting option and early results.

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