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Muscle fibre activation and fatigue with low-load blood flow restricted resistance exercise—An integrative physiology review

Artikel i vetenskaplig tidskrift
Författare Mathias Wernbom
P. Aagaard
Publicerad i Acta Physiologica
Volym 228
Nummer/häfte 1
ISSN 1748-1708
Publiceringsår 2020
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för hälsa och rehabilitering
Institutionen för kost- och idrottsvetenskap
Språk en
Länkar dx.doi.org/10.1111/apha.13302
Ämnesord fatigue, ischemia, motor units, muscle hypertrophy, occlusion
Ämneskategorier Invärtesmedicin


Blood flow-restricted resistance exercise (BFRRE) has been shown to induce increases in muscle size and strength, and continues to generate interest from both clinical and basic research points of view. The low loads employed, typically 20%-50% of the one repetition maximum, make BFRRE an attractive training modality for individuals who may not tolerate high musculoskeletal forces (eg, selected clinical patient groups such as frail old adults and patients recovering from sports injury) and/or for highly trained athletes who have reached a plateau in muscle mass and strength. It has been proposed that achieving a high degree of muscle fibre recruitment is important for inducing muscle hypertrophy with BFRRE, and the available evidence suggest that fatiguing low-load exercise during ischemic conditions can recruit both slow (type I) and fast (type II) muscle fibres. Nevertheless, closer scrutiny reveals that type II fibre activation in BFRRE has to date largely been inferred using indirect methods such as electromyography and magnetic resonance spectroscopy, while only rarely addressed using more direct methods such as measurements of glycogen stores and phosphocreatine levels in muscle fibres. Hence, considerable uncertainity exists about the specific pattern of muscle fibre activation during BFRRE. Therefore, the purpose of this narrative review was (1) to summarize the evidence on muscle fibre recruitment during BFRRE as revealed by various methods employed for determining muscle fibre usage during exercise, and (2) to discuss reported findings in light of the specific advantages and limitations associated with these methods. © 2019 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd

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