Blood Flow Restriction Training and Central Hemodynamics


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Blood Flow Restriction Training and Central Hemodynamics
Nicholas M. Licameli, PT,DPT




During any type of exercise, there is a change in peripheral blood pressure to match the demands of the task. However, not many people consider that there is also a change in central hemodynamics – namely the pressure that the aorta experiences with every pump of the heart. This is known as central blood pressure.

Central blood pressure elevations can be potentially detrimental to an individual because it makes the heart work harder to get the blood through to the exercising muscles and the rest of the body. Over time, increases in central blood pressure can create changes in the ability of the artery to vasodilate – known as arterial stiffness. Chronically, higher values of arterial stiffness has been thought to contribute to adverse events in the cardiovascular system.

In order for BFR training to be deemed as safe, it should not pose a significantly higher ability to change central hemodynamics over heavy-load alternatives. This systematic review attempts to synthesize the current level of evidence on central hemodynamic changes with BFR training.

The authors conclude that, 

“More research on healthy and at-risk populations is needed to make stronger recommendations on the acute and long-term central hemodynamic effects of low intensity resistance exercise with BFR (LIREBFR) performed with personalized pressures and intermittent application. The current body of literature within this systematic review suggests that these two approaches could be used in practice to attenuate the central hemodynamic response to LIREBFR exercise. However, as no studies have incorporated both approaches together in one intervention, future research should determine the acute safety and long-term efficacy (muscle mass, strength etc.) of a combined approach before stronger practical recommendations can be given.”

What’s the takeaway? We need way more research!


Amorim S, Rolnick N, Schoenfeld BJ, Aagaard P. Low-intensity resistance exercise with blood flow restriction and arterial stiffness in humans: A systematic review. Scand J Med Sci Sports. 2021 Mar;31(3):498-509. doi: 10.1111/sms.13902. Epub 2020 Dec 22. PMID: 33283322.


****Remember, the decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.

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