Muscle Damage, Muscle Weakness
Conditions
Keywords
resistance training, blood flow restriction, exercise induced muscle damage, muscle swelling, occlusion
Brief summary
The Academic Department of Military Rehabilitation (ADMR) is currently conducting a pan-defence, randomised control trial (RCT) investigating the utility of twice daily blood flow restriction training in UK military personnel with persistent knee pain (NCT05719922). Due to logistical confinements, this pan-defence RCT is confined to collecting outcome data pre and post-intervention. Therefore, the acute physiological mechanisms which underpin adaptation will remain unknown. Consequently, ADMR is undertaking an additional, single centre RCT which will compare the acute physiological responses to low load resistance training with and without the addition of blood flow restriction. Specifically, this study will elucidate the effect of twice daily blood flow restriction training on measures of muscle swelling, muscle damage and inflammation. This data may aid in the optimisation of blood flow restriction exercise prescription within UK Defence Rehabilitation and elsewhere.
Interventions
DEVICELow load resistance training with blood flow restriction
The intervention involves placing a pneumatic tourniquet system over the proximal thigh. The cuff is inflated to 80% of limb occlusion pressure during lower limb strengthening exercises. These exercises include leg press and knee extensor exercises. Four sets (30,15,15,15 repetitions) performed at 20% of one repetition maximum.
Leg press and knee extensor exercises. Four sets (30,15,15,15 repetitions) performed at 20% of one repetition maximum.
Sponsors
University of Bath
Defence Medical Rehabilitation Centre, UK
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Masking description
Due to the nature of the intervention, it is not possible to blind participants or outcome assessors to the treatment allocation. There is also no effective sham condition available. This is a common limitation within all blood flow restriction training research.
Intervention model description
Two arm randomised control trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18 - 55 years * Must not have performed regular lower-limb resistance training for the last 6 months (participants must have performed \< 1 lower-limb resistance training session per week over the previous 6 months) * DMRC Staff member (civilian or service personnel)
Exclusion criteria
* Any medical contraindication related to BFR\*. * Any current lower-limb musculoskeletal injury * Restricted range of movement. i.e. Chronically locked knee or fixed flexion deformity. * Any physical impairment or co-morbidities (including cardio-vascular disease) precluding the safe participation in the intervention and/or assessment procedures * Non-musculoskeletal or serious pathological condition (i.e. Inflammatory arthropathy, infection or tumour). * Use of any medication which may contraindicate the performance of BFR or influence blood biomarkers of EIMD or inflammation. * Use of any performance enhancing supplements or ergogenic aids such as creatine monohydrate. * Any individual who is known to be currently pregnant \*Medical-based
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum isometric voluntary contraction of knee extensor muscles | Measures collected in the morning on day 1,2,3,4,5,8. Measures also performed immediately before and 30 seconds after exercise on day 1 and 4 | Measured using an isokinetic dynamometer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Venous blood sampling for markers of exercise induced muscle damage | Measures collected in the morning on day 1,2,4,5,8. Measures also performed before, 10 min after and 4 hours after exercise on day 1 | Venous blood samples to measure markers of exercise induced muscle damage. E.g., Creatine Kinase (units/L) |
| Delayed onset muscle soreness | Measures collected in the morning on day 1,2,3,4,5,8 | Measured using a 100 mm visual analog scale. A higher score indicates greater levels of muscle soreness. |
| Quadriceps discomfort | Measured immediately after each exercise session | Measured immediately after each exercise session using a 100 mm visual analog scale. A higher score indicates greater levels of discomfort. |
| Discomfort caused by the BFR cuff | Measured immediately after each exercise session | Measured in the intervention group immediately after each exercise session using a 100 mm visual analog scale. A higher score indicates greater levels of discomfort. |
| Vastus lateralis muscle thickness | Measures collected in the morning on day 1,2,3,4,5,8. Measures also performed before, 3 min after and 4 hours after exercise on day 1 and 4 | Measured using B-Mode ultrasound |
| Knee joint range of motion | Measures collected in the morning on day 1,2,3,4,5,8 | measured using a goniometer |
| Daily wellness questionnaire | Measures collected in the morning on day 1,2,3,4,5,8 | UK Defence Rehabilitation daily wellness questionnaire. This questionnaire asks participants to rate their: fatigue, muscle soreness, sleep quality, stress levels and mood on a 1-5 Likert scale. |
| Venous blood sampling for inflammatory markers | Measures collected in the morning on day 1,2,4,5,8. Measures also performed before, 10 min after and 4 hours after exercise on day 1 | Venous blood samples to measure markers of inflammation. E.g., Interleukin-6 (pg/ml), Tumour necrosis factor alpha (pg/mL) and vascular endothelial growth factor (pg/mL). |
| Rating of perceived exertion | Measured immediately after each exercise session | Measured using a Borg 0-10 rating of perceived exertion scale. A higher score represents greater levels of exertion. |
Countries
United Kingdom
Contacts
Primary ContactPeter Ladlow, PhD
Backup ContactRuss Coppack, PhD
Outcome results
None listed