BFR: Low Intensity Exercise


In the last post, we focused on how to initiate the return to function progression with applied BFR following injury or other causes of bed rest. The 2nd rung on the ladder that leads to return to function would be application of BFR in combination with low-load, endurance training.


As soon as weight bearing can be tolerated, a shift towards endurance training with BFR becomes an option. Previously, it’s been shown that with the elderly (without BFR)., endurance training at 60-80% of heart rate reserve (higher intensity) can lead to increased muscle mass and strength (type 2 fibers). (Harber et al)


 It has also been shown that the use of BFR can achieve improvements in muscle function at much lower intensities than 60-80% of HRR (which is a positive when first progressing back to weight bearing). In one study, it was shown that increases in muscle mass and VO2 max could be achieved in this same population at 45% of heart rate reserve (Ozaki et al). Not only that, but carotid artery compliance improved in this study as well (cardiovascular health).


If full weight bearing can’t be consistently tolerated, low intensity stationary cycling with BFR at 40% of V02 max (relatively low exertion) can significantly impact muscle size as well (8 week study).


Basically, low intensity walking, cycling, or some combination of both supplemented with BFR for a minimum of 2 days per week after a period of bed rest can be sufficient to improve cardiovascular and musculoskeletal health.


Just like with the application of BFR during bed rest, application for BFR in the early phases of transitioning to light activity can prevent atrophy and encourage the improvement of vo2 max and lean body mass (strength) that will set the stage for further growth in the future.


Once further resistance can be tolerated, the next step in the progression to full functional tolerance of daily activity would be the addition of low-load resistance training, which we will talk about on the next post.


Stay tuned for more in this series. If you’d like to find out more, or think you could potentially benefit from one-on-one physical therapy in the Daphne area, please feel free to contact us.


Tyler Vaughn
Owner Pathology Apparel
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