Kan Akışı Kısıtlamalı Direnç Egzersizin Kalp Atım Hızı Değişkenliği Üzerine Akut Etkisi
Year 2025,
Volume: 17 Issue: 1, 1 - 17, 26.03.2025
Veli Volkan Gürses
,
Kamil Uzgur
,
Okan Kamiş
,
Mustafa Altunsoy
,
Hacı Ahmet Pekel
Abstract
It is recommended that low-load resistance exercise with blood flow restriction be employed
as an alternative method for individuals unable to perform traditional high-load resistance exercise. This
study investigated the acute effects of low-load resistance exercise with blood flow restriction (BFR-RE)
and traditional high-load resistance exercise (HL-RE) on heart rate variability. Sixteen recreational male
participants aged 18-24 volunteered to participate in the study and 14 completed the study. Participants
were randomly divided into two groups (BFR-RE:8, HL-RE:8). The BFR-RE group performed the leg
press exercise (30-15-15-15 reps, 30-seconds rest between sets, 30% of 1RM) with BFR cuffs (60% of
arterial occlusion pressure). The HL-RE group performed the same exercise (3 x 12 reps, 90 seconds
rest between the sets, 70% 1RM) without BFR cuffs. Heart rate, variability, and time domain parameters
were assessed using the POLAR H7 heart rate monitor with the Elite HRV mobile application. Twoway
analysis of variance (ANOVA) with 2×2 repeated measures was used to analyze differences between
groups. Significance was set at p<0.05. The BFR-RE group exhibited more pronounced statistically
significant differences in heart rate variability parameters than the HL-RE group. In conclusion, this
study found that BFR-RE exerts a more pronounced effect on cardiac and cardiovascular autonomic
function parameters than HL-RE.
Ethical Statement
Ethical approval for this study was given at the local Bandırma University Ethics Committee meeting on 12.07.2024, with the decision number E-77082166-604.01-995086. This study was conducted following the principles of the Declaration of Helsinki.
References
- Arakaki, X., Arechavala, R. J., Choy, E. H., Bautista, J., Bliss, B., Molloy, C., Wu, D. A., Shimojo, S., Jiang, Y., Kleinman, M. T., & Kloner, R. A. (2023). The connection between heart rate variability (HRV), neurological health, and cognition: A literature review. Frontiers in Neuroscience, 17, 1055445. https://doi.org/10.3389/fnins.2023.1055445
- Azegami, M., Yanagihashi, R., Miyoshi, K., Akahane, K., Ohira, M., & Sadoyama, T. (2007). Effects of multi-joint angle changes on EMG activity and force of lower extremity muscles during maximum isometric leg press exercises. Journal of Physical Therapy Science, 19(1), 65-72.
- Bakeman R. (2005). Recommended effect size statistics for repeated measures designs. Behavior research methods, 37, 379–384, 2005.
Bazgir, B., Rezazadeh Valojerdi, M., Rajabi, H., Fathi, R., Ojaghi, S. M., Emami Meybodi, M. K., Neto, G. R., Rahimi, M., & Asgari, A. (2016). Acute Cardiovascular and Hemodynamic Responses to Low Intensity Eccentric Resistance Exercise with Blood Flow Restriction. Asian Journal of Sports Medicine, 7(4), e38458. https://doi.org/10.5812/asjsm.38458
- Bishop, P. A., Jones, E., & Woods, A. K. (2008). Recovery from training: a brief review: brief review. The Journal of Strength & Conditioning Research, 22(3), 1015-1024.
- Blouin, J. E., Gyurcsik, N. C., Tupper, S. M., Brittain, D. R., Ratcliffe-Smith, D., Brawley, L. R., Cary, M. A., Marchant, M. G., Hellsten, L.-A. M., & Arnold, B. E. (2019). Evaluation of chronic pain and physical activity training on providers' pain knowledge and self-efficacy. Journal of Exercise, Movement, and Sport (SCAPPS refereed abstracts repository), 51(1).
- Castello-Simoes, V., Polaquini Simões, R., Beltrame, T., Bassi, D., Maria Catai, A., Arena, R., Azambuja Jr, N. C., Nascimento Ortega, J. d., & Borghi-Silva, A. (2013). Effects of aerobic exercise training on variability and heart rate kinetic during submaximal exercise after gastric bypass surgery–a randomized controlled trial. Disability and Rehabilitation, 35(4), 334-342.
- Centner, C., Wiegel, P., Gollhofer, A., & Konig, D. (2019). Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: A systematic review and meta-analysis. Sports Medicine, 49(1), 95-108. https://doi.org/10.1007/s40279-018-0994-1
- Cerqueira, M. S., Costa, E. C., Santos Oliveira, R., Pereira, R., & Brito Vieira, W. H. (2021). Blood Flow Restriction Training: To Adjust or Not Adjust the Cuff Pressure Over an Intervention Period? Frontiers in Physiology, 12, 678407. https://doi.org/10.3389/fphys.2021.678407
- Chen, Y. C., Lo, I. P., Tsai, Y. Y., Zhao, C. G., & Hwang, I. S. (2024). Dual-task improvement of older adults after treadmill walking combined with blood flow restriction of low occlusion pressure: the effect on the heart–brain axis. Journal of Neuro Engineering and Rehabilitation, 21(1), 116.
- Clarkson, M. J., Conway, L., & Warmington, S. A. (2017). Blood flow restriction walking and physical function in older adults: A randomized control trial. Journal of Science and Medicine in Sport, 20(12), 1041-1046. https://doi.org/10.1016/j.jsams.2017.04.012
- Crisafulli, A., de Farias, R. R., Farinatti, P., Lopes, K. G., Milia, R., Sainas, G., Pinna, V., Palazzolo, G., Doneddu, A., Magnani, S., Mulliri, G., Roberto, S., & Oliveira, R. B. (2018). Blood Flow Restriction Training Reduces Blood Pressure During Exercise Without Affecting Metaboreflex Activity. Frontiers in Physiology, 9, 1736. https://doi.org/10.3389/fphys.2018.01736
- Dong, J. G. (2016). The role of heart rate variability in sports physiology. Experimental and therapeutic medicine, 11(5), 1531-1536. https://doi.org/10.3892/etm.2016.3104
- Draghici, A. E., & Taylor, J. A. (2016). The physiological basis and measurement of heart rate variability in humans. Journal of Physiological Anthropology, 35(1), 22. https://doi.org/10.1186/s40101-016-0113-7
- Ferguson, R. A., Mitchell, E. A., Taylor, C. W., Bishop, D. J., & Christiansen, D. (2021). Blood‐flow‐restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance‐trained athlete. Experimental Physiology, 106(4), 837-860.
- Ferreira Junior, A., Schamne, J. C., Altimari, L. R., Okano, A. H., & Okuno, N. M. (2019). Effect of walk training combined with blood flow restriction on resting heart rate variability and resting blood pressure in middle-aged men. Motriz: Revista de Educação Física, 25(2), e101945.1-6.
- Ferreira, M. L. V., Sardeli, A. V., Souza, G. V., Bonganha, V., Santos, L. D. C., Castro, A., Cavaglieri, C. R., & Chacon-Mikahil, M. P. T. (2017). Cardiac autonomic and haemodynamic recovery after a single session of aerobic exercise with and without blood flow restriction in older adults. Journal of Sports Sciences, 35(24), 2412-2420. https://doi.org/10.1080/02640414.2016.1271139
- Haff, G. G., & Triplett, N. T. (2016). Essentials of Strength Training and Conditioning (G. G. Haff & N. T. Triplett, Eds. 4th ed.). Human Kinetics.
- Hautala, A. J., Kiviniemi, A. M., & Tulppo, M. P. (2009). Individual responses to aerobic exercise: the role of the autonomic nervous system. Neuroscience & Biobehavioral Reviews, 33(2), 107-115. https://doi.org/10.1016/j.neubiorev.2008.04.009
- Holmes, C. J., MacDonald, H. V., Esco, M. R., Fedewa, M. V., Wind, S. A., & Winchester, L. J. (2022). Comparison of Heart Rate Variability Responses to Varying Resistance Exercise Volume-Loads. Research Quarterly for Exercise and Sport, 93(2), 391-400. https://doi.org/10.1080/02701367.2020.1851351
- Horiuchi, M., & Okita, K. (2012). Blood flow restricted exercise and vascular function. International Journal of Vascular Medicine, 2012, 543218. https://doi.org/10.1155/2012/543218
- Jørgensen, S. L., Kierkegaard-Brøchner, S., Bohn, M. B., Høgsholt, M., Aagaard, P., & Mechlenburg, I. (2023). Effects of blood-flow restricted exercise versus conventional resistance training in musculoskeletal disorders—a systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 15(1), 141, 1-14.
- Junior, A. F., Schamne, J. C., Perandini, L. A. B., Chimin, P., & Okuno, N. M. (2019). Effects of walking training with restricted blood flow on HR and HRV kinetics and HRV recovery. International Journal of Sports Medicine, 40(09), 585-591.
- Kamiş, O., Gürses, V. V., Şendur, H. N., Altunsoy, M., Pekel, H. A., Yıldırım, E., & Aydos, L. (2024). Low-load resistance exercise with blood flow restriction versus high-load resistance exercise on hamstring muscle adaptations in recreationally trained men. The Journal of Strength & Conditioning Research, 38(10), e541-e552.
- Larkin, K. A., Macneil, R. G., Dirain, M., Sandesara, B., Manini, T. M., & Buford, T. W. (2012). Blood flow restriction enhances post-resistance exercise angiogenic gene expression. Medicine and Science in Sports and Exercise, 44(11), 2077-2083. https://doi.org/10.1249/MSS.0b013e3182625928
- Loenneke, J. P., Abe, T., Wilson, J. M., Ugrinowitsch, C., & Bemben, M. G. (2012). Blood flow restriction: how does it work? Frontiers in Physiology, 3, 392, 1-2. https://doi.org/10.3389/fphys.2012.00392
- Loenneke, J. P., Thiebaud, R. S., & Abe, T. (2013). The application of blood flow restriction training into Western medicine: isn't it about time? Journal of Alternative and cComplementary Medicine (New York, NY), 19(10), 843-844.
- Lopes, K. G., Farinatti, P., Bottino, D. A., MDGC, D. E. S., Maranhao, P. A., Bouskela, E., Lourenco, R. A., & RB, D. E. O. (2021). Does Resistance Training with Blood Flow Restriction Affect Blood Pressure and Cardiac Autonomic Modulation in Older Adults? International Journal of Exercise Science, 14(3), 410-422. https://www.ncbi.nlm.nih.gov/pubmed/34055161
- Manoli, I., Alesci, S., Blackman, M. R., Su, Y. A., Rennert, O. M., & Chrousos, G. P. (2007). Mitochondria as key components of the stress response. Trends in Endocrinology & Metabolism, 18(5), 190-198. https://doi.org/10.1016/j.tem.2007.04.004
- Miller, B. C., Tirko, A. W., Shipe, J. M., Sumeriski, O. R., & Moran, K. (2021). The systemic effects of blood flow restriction training: a systematic review. International Journal of Sports Physical Therapy, 16(4), 978-990.
- Miller, T., Nicks, C., Tyo, B., & Early, K. (2022). Heart rate variability in response to blood flow restriction training and reduced sedentary time: a pilot study. International Journal of Exercise Science: Conference Proceedings. 16(1), 325.
- Neto, G. R., Novaes, J. S., Dias, I., Brown, A., Vianna, J., & Cirilo-Sousa, M. S. (2017). Effects of resistance training with blood flow restriction on haemodynamics: a systematic review. Clinical Physiology and Functional Imaging, 37(6), 567-574. https://doi.org/10.1111/cpf.12368
- Olfert, I. M., Breen, E. C., Mathieu-Costello, O., & Wagner, P. D. (2001). Skeletal muscle capillarity and angiogenic mRNA levels after exercise training in normoxia and chronic hypoxia. Journal of Applied Physiology (1985), 91(3), 1176-1184. https://doi.org/10.1152/jappl.2001.91.3.1176
- Parati, G., & Ochoa, J. E. (2012). Effects of physical training on autonomic cardiac modulation in hypertension: assessment by heart rate variability analysis. Hypertension Research, 35(1), 25-27. https://doi.org/10.1038/hr.2011.179
- Park, S. Y., Kwak, Y. S., Harveson, A., Weavil, J. C., & Seo, K. E. (2015). Low intensity resistance exercise training with blood flow restriction: insight into cardiovascular function, and skeletal muscle hypertrophy in humans. The Korean Journal of Physiology & Pharmacology, 19(3), 191-196. https://doi.org/10.4196/kjpp.2015.19.3.191
- Patterson, S. D., Hughes, L., Warmington, S., Burr, J., Scott, B. R., Owens, J., Abe, T., Nielsen, J. L., Libardi, C. A., & Laurentino, G. (2019). Blood flow restriction exercise: considerations of methodology, application, and safety. Frontiers in Physiology, 10, 533.
- Pinto, R. R., & Polito, M. D. (2016). Haemodynamic responses during resistance exercise with blood flow restriction in hypertensive subjects. Clinical Physiology and Functional Imaging, 36(5), 407-413. https://doi.org/10.1111/cpf.12245
- Reina-Ruiz, A. J., Galan-Mercant, A., Molina-Torres, G., Merchan-Baeza, J. A., Romero-Galisteo, R. P., & Gonzalez-Sanchez, M. (2022). Effect of Blood Flow Restriction on Functional, Physiological and Structural Variables of Muscle in Patients with Chronic Pathologies: A Systematic Review. International Journal of Environmental Research and Public Health, 19(3), 1-27. https://doi.org/10.3390/ijerph19031160
- Schamne, J. C., Ferreira, A., Araújo, A. C. D., Lima-Silva, A. E., Bertuzzi, R. C. D. M., & Okuno, N. M. (2019). Cardiac autonomic responses during and after a single session of aerobic exercise with and without blood flow restriction. Motriz: Revista de Educação Física, 25(3), e101936, 1-7.
- Scott, B. R., Loenneke, J. P., Slattery, K. M., & Dascombe, B. J. (2015). Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports medicine, 45, 313-325.
- Sheppard, J. M., & Triplett, N. T. (2016). Program design for resistance training. Essentials of strength training and conditioning (4th ed.). Champaign, IL: Human Kinetics, 439-470.
- Souza, H. C. D., Philbois, S. V., Veiga, A. C., & Aguilar, B. A. (2021). Heart Rate Variability and Cardiovascular Fitness: What We Know so Far. Vascular Health and Risk Management, 17(1), 701-711. https://doi.org/10.2147/VHRM.S279322
- Sun, Y., Hu, S., Azorin-Peris, V., Greenwald, S., Chambers, J., & Zhu, Y. (2011). Motion-compensated noncontact imaging photoplethysmography to monitor cardiorespiratory status during exercise. Journal of Biomedical Optics, 16(7), 077010-077010-9. https://doi.org/10.1117/1.3602852
- Thiel, K. J., & Dretsch, M. N. (2011). The basics of the stress response: A historical context and introduction. The handbook of stress: Neuropsychological Effects on The Brain, 1-28.
- Thomas, H. J., Scott, B. R., & Peiffer, J. J. (2018). Acute physiological responses to low-intensity blood flow restriction cycling. Journal of Science and Medicine in Sport, 21(9), 969-974. https://doi.org/10.1016/j.jsams.2018.01.013
- Yasuda, T., Ogasawara, R., Sakamaki, M., Ozaki, H., Sato, Y., & Abe, T. (2011). Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size. European Journal of Applied Physiology, 111(10), 2525-2533. https://doi.org/10.1007/s00421-011-1873-8
- Yuan, J., Wu, L., Xue, Z., Xu, G., & Wu, Y. (2023). Application and progress of blood flow restriction training improves muscle mass and strength in the elderly. Frontiers in Physiology, 14, 1155314, 1-9. https://doi.org/10.3389/fphys.2023.1155314
Acute Effects of Blood Flow Restricted Resistance Exercise on Heart Rate Variability
Year 2025,
Volume: 17 Issue: 1, 1 - 17, 26.03.2025
Veli Volkan Gürses
,
Kamil Uzgur
,
Okan Kamiş
,
Mustafa Altunsoy
,
Hacı Ahmet Pekel
Abstract
It is recommended that low-load resistance exercise with blood flow restriction be employed
as an alternative method for individuals unable to perform traditional high-load resistance exercise. This
study investigated the acute effects of low-load resistance exercise with blood flow restriction (BFR-RE)
and traditional high-load resistance exercise (HL-RE) on heart rate variability. Sixteen recreational male
participants aged 18-24 volunteered to participate in the study and 14 completed the study. Participants
were randomly divided into two groups (BFR-RE:8, HL-RE:8). The BFR-RE group performed the leg
press exercise (30-15-15-15 reps, 30-seconds rest between sets, 30% of 1RM) with BFR cuffs (60% of
arterial occlusion pressure). The HL-RE group performed the same exercise (3 x 12 reps, 90 seconds
rest between the sets, 70% 1RM) without BFR cuffs. Heart rate, variability, and time domain parameters
were assessed using the POLAR H7 heart rate monitor with the Elite HRV mobile application. Twoway
analysis of variance (ANOVA) with 2×2 repeated measures was used to analyze differences between
groups. Significance was set at p<0.05. The BFR-RE group exhibited more pronounced statistically
significant differences in heart rate variability parameters than the HL-RE group. In conclusion, this
study found that BFR-RE exerts a more pronounced effect on cardiac and cardiovascular autonomic
function parameters than HL-RE.
Ethical Statement
Ethical approval for this study was given at the local Bandırma University Ethics Committee meeting on 12.07.2024, with the decision number E-77082166-604.01-995086. This study was conducted following the principles of the Declaration of Helsinki.
References
- Arakaki, X., Arechavala, R. J., Choy, E. H., Bautista, J., Bliss, B., Molloy, C., Wu, D. A., Shimojo, S., Jiang, Y., Kleinman, M. T., & Kloner, R. A. (2023). The connection between heart rate variability (HRV), neurological health, and cognition: A literature review. Frontiers in Neuroscience, 17, 1055445. https://doi.org/10.3389/fnins.2023.1055445
- Azegami, M., Yanagihashi, R., Miyoshi, K., Akahane, K., Ohira, M., & Sadoyama, T. (2007). Effects of multi-joint angle changes on EMG activity and force of lower extremity muscles during maximum isometric leg press exercises. Journal of Physical Therapy Science, 19(1), 65-72.
- Bakeman R. (2005). Recommended effect size statistics for repeated measures designs. Behavior research methods, 37, 379–384, 2005.
Bazgir, B., Rezazadeh Valojerdi, M., Rajabi, H., Fathi, R., Ojaghi, S. M., Emami Meybodi, M. K., Neto, G. R., Rahimi, M., & Asgari, A. (2016). Acute Cardiovascular and Hemodynamic Responses to Low Intensity Eccentric Resistance Exercise with Blood Flow Restriction. Asian Journal of Sports Medicine, 7(4), e38458. https://doi.org/10.5812/asjsm.38458
- Bishop, P. A., Jones, E., & Woods, A. K. (2008). Recovery from training: a brief review: brief review. The Journal of Strength & Conditioning Research, 22(3), 1015-1024.
- Blouin, J. E., Gyurcsik, N. C., Tupper, S. M., Brittain, D. R., Ratcliffe-Smith, D., Brawley, L. R., Cary, M. A., Marchant, M. G., Hellsten, L.-A. M., & Arnold, B. E. (2019). Evaluation of chronic pain and physical activity training on providers' pain knowledge and self-efficacy. Journal of Exercise, Movement, and Sport (SCAPPS refereed abstracts repository), 51(1).
- Castello-Simoes, V., Polaquini Simões, R., Beltrame, T., Bassi, D., Maria Catai, A., Arena, R., Azambuja Jr, N. C., Nascimento Ortega, J. d., & Borghi-Silva, A. (2013). Effects of aerobic exercise training on variability and heart rate kinetic during submaximal exercise after gastric bypass surgery–a randomized controlled trial. Disability and Rehabilitation, 35(4), 334-342.
- Centner, C., Wiegel, P., Gollhofer, A., & Konig, D. (2019). Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: A systematic review and meta-analysis. Sports Medicine, 49(1), 95-108. https://doi.org/10.1007/s40279-018-0994-1
- Cerqueira, M. S., Costa, E. C., Santos Oliveira, R., Pereira, R., & Brito Vieira, W. H. (2021). Blood Flow Restriction Training: To Adjust or Not Adjust the Cuff Pressure Over an Intervention Period? Frontiers in Physiology, 12, 678407. https://doi.org/10.3389/fphys.2021.678407
- Chen, Y. C., Lo, I. P., Tsai, Y. Y., Zhao, C. G., & Hwang, I. S. (2024). Dual-task improvement of older adults after treadmill walking combined with blood flow restriction of low occlusion pressure: the effect on the heart–brain axis. Journal of Neuro Engineering and Rehabilitation, 21(1), 116.
- Clarkson, M. J., Conway, L., & Warmington, S. A. (2017). Blood flow restriction walking and physical function in older adults: A randomized control trial. Journal of Science and Medicine in Sport, 20(12), 1041-1046. https://doi.org/10.1016/j.jsams.2017.04.012
- Crisafulli, A., de Farias, R. R., Farinatti, P., Lopes, K. G., Milia, R., Sainas, G., Pinna, V., Palazzolo, G., Doneddu, A., Magnani, S., Mulliri, G., Roberto, S., & Oliveira, R. B. (2018). Blood Flow Restriction Training Reduces Blood Pressure During Exercise Without Affecting Metaboreflex Activity. Frontiers in Physiology, 9, 1736. https://doi.org/10.3389/fphys.2018.01736
- Dong, J. G. (2016). The role of heart rate variability in sports physiology. Experimental and therapeutic medicine, 11(5), 1531-1536. https://doi.org/10.3892/etm.2016.3104
- Draghici, A. E., & Taylor, J. A. (2016). The physiological basis and measurement of heart rate variability in humans. Journal of Physiological Anthropology, 35(1), 22. https://doi.org/10.1186/s40101-016-0113-7
- Ferguson, R. A., Mitchell, E. A., Taylor, C. W., Bishop, D. J., & Christiansen, D. (2021). Blood‐flow‐restricted exercise: Strategies for enhancing muscle adaptation and performance in the endurance‐trained athlete. Experimental Physiology, 106(4), 837-860.
- Ferreira Junior, A., Schamne, J. C., Altimari, L. R., Okano, A. H., & Okuno, N. M. (2019). Effect of walk training combined with blood flow restriction on resting heart rate variability and resting blood pressure in middle-aged men. Motriz: Revista de Educação Física, 25(2), e101945.1-6.
- Ferreira, M. L. V., Sardeli, A. V., Souza, G. V., Bonganha, V., Santos, L. D. C., Castro, A., Cavaglieri, C. R., & Chacon-Mikahil, M. P. T. (2017). Cardiac autonomic and haemodynamic recovery after a single session of aerobic exercise with and without blood flow restriction in older adults. Journal of Sports Sciences, 35(24), 2412-2420. https://doi.org/10.1080/02640414.2016.1271139
- Haff, G. G., & Triplett, N. T. (2016). Essentials of Strength Training and Conditioning (G. G. Haff & N. T. Triplett, Eds. 4th ed.). Human Kinetics.
- Hautala, A. J., Kiviniemi, A. M., & Tulppo, M. P. (2009). Individual responses to aerobic exercise: the role of the autonomic nervous system. Neuroscience & Biobehavioral Reviews, 33(2), 107-115. https://doi.org/10.1016/j.neubiorev.2008.04.009
- Holmes, C. J., MacDonald, H. V., Esco, M. R., Fedewa, M. V., Wind, S. A., & Winchester, L. J. (2022). Comparison of Heart Rate Variability Responses to Varying Resistance Exercise Volume-Loads. Research Quarterly for Exercise and Sport, 93(2), 391-400. https://doi.org/10.1080/02701367.2020.1851351
- Horiuchi, M., & Okita, K. (2012). Blood flow restricted exercise and vascular function. International Journal of Vascular Medicine, 2012, 543218. https://doi.org/10.1155/2012/543218
- Jørgensen, S. L., Kierkegaard-Brøchner, S., Bohn, M. B., Høgsholt, M., Aagaard, P., & Mechlenburg, I. (2023). Effects of blood-flow restricted exercise versus conventional resistance training in musculoskeletal disorders—a systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 15(1), 141, 1-14.
- Junior, A. F., Schamne, J. C., Perandini, L. A. B., Chimin, P., & Okuno, N. M. (2019). Effects of walking training with restricted blood flow on HR and HRV kinetics and HRV recovery. International Journal of Sports Medicine, 40(09), 585-591.
- Kamiş, O., Gürses, V. V., Şendur, H. N., Altunsoy, M., Pekel, H. A., Yıldırım, E., & Aydos, L. (2024). Low-load resistance exercise with blood flow restriction versus high-load resistance exercise on hamstring muscle adaptations in recreationally trained men. The Journal of Strength & Conditioning Research, 38(10), e541-e552.
- Larkin, K. A., Macneil, R. G., Dirain, M., Sandesara, B., Manini, T. M., & Buford, T. W. (2012). Blood flow restriction enhances post-resistance exercise angiogenic gene expression. Medicine and Science in Sports and Exercise, 44(11), 2077-2083. https://doi.org/10.1249/MSS.0b013e3182625928
- Loenneke, J. P., Abe, T., Wilson, J. M., Ugrinowitsch, C., & Bemben, M. G. (2012). Blood flow restriction: how does it work? Frontiers in Physiology, 3, 392, 1-2. https://doi.org/10.3389/fphys.2012.00392
- Loenneke, J. P., Thiebaud, R. S., & Abe, T. (2013). The application of blood flow restriction training into Western medicine: isn't it about time? Journal of Alternative and cComplementary Medicine (New York, NY), 19(10), 843-844.
- Lopes, K. G., Farinatti, P., Bottino, D. A., MDGC, D. E. S., Maranhao, P. A., Bouskela, E., Lourenco, R. A., & RB, D. E. O. (2021). Does Resistance Training with Blood Flow Restriction Affect Blood Pressure and Cardiac Autonomic Modulation in Older Adults? International Journal of Exercise Science, 14(3), 410-422. https://www.ncbi.nlm.nih.gov/pubmed/34055161
- Manoli, I., Alesci, S., Blackman, M. R., Su, Y. A., Rennert, O. M., & Chrousos, G. P. (2007). Mitochondria as key components of the stress response. Trends in Endocrinology & Metabolism, 18(5), 190-198. https://doi.org/10.1016/j.tem.2007.04.004
- Miller, B. C., Tirko, A. W., Shipe, J. M., Sumeriski, O. R., & Moran, K. (2021). The systemic effects of blood flow restriction training: a systematic review. International Journal of Sports Physical Therapy, 16(4), 978-990.
- Miller, T., Nicks, C., Tyo, B., & Early, K. (2022). Heart rate variability in response to blood flow restriction training and reduced sedentary time: a pilot study. International Journal of Exercise Science: Conference Proceedings. 16(1), 325.
- Neto, G. R., Novaes, J. S., Dias, I., Brown, A., Vianna, J., & Cirilo-Sousa, M. S. (2017). Effects of resistance training with blood flow restriction on haemodynamics: a systematic review. Clinical Physiology and Functional Imaging, 37(6), 567-574. https://doi.org/10.1111/cpf.12368
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