Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia

IntroductionLow-load resistance training with concurrent blood flow restriction (BFR) provides strength and hypertrophy benefits to healthy individuals and some clinical populations. This is the first study assessing safety and physiological responses of autoregulated (AUTO) and non-autoregulated (N...

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Main Authors: Daniel C. Ogrezeanu, Andrea Tur-Boned, Nicholas Rolnick, Juan J. Carrasco, Carlos Cruz-Montecinos, Joaquín Calatayud, Santiago Bonanad, Sofía Pérez-Alenda
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Sports and Active Living
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Online Access:https://www.frontiersin.org/articles/10.3389/fspor.2025.1587615/full
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author Daniel C. Ogrezeanu
Andrea Tur-Boned
Nicholas Rolnick
Nicholas Rolnick
Juan J. Carrasco
Juan J. Carrasco
Carlos Cruz-Montecinos
Carlos Cruz-Montecinos
Joaquín Calatayud
Santiago Bonanad
Sofía Pérez-Alenda
author_facet Daniel C. Ogrezeanu
Andrea Tur-Boned
Nicholas Rolnick
Nicholas Rolnick
Juan J. Carrasco
Juan J. Carrasco
Carlos Cruz-Montecinos
Carlos Cruz-Montecinos
Joaquín Calatayud
Santiago Bonanad
Sofía Pérez-Alenda
author_sort Daniel C. Ogrezeanu
collection DOAJ
description IntroductionLow-load resistance training with concurrent blood flow restriction (BFR) provides strength and hypertrophy benefits to healthy individuals and some clinical populations. This is the first study assessing safety and physiological responses of autoregulated (AUTO) and non-autoregulated (NAUTO) BFR protocols in people with hemophilia (PWH). Therefore, this study aimed to evaluate the acute safety, cardiovascular, neuromuscular and perceptual responses during AUTO and NAUTO BFR training in PWH.MethodsEleven severe PWH under prophylaxis performed two sessions of elbow flexion and extension using elastic bands at 50% of the limb occlusion pressure (LOP) with different BFR settings (AUTO vs. NAUTO). Safety, cardiovascular parameters, rating of perceived exertion, elbow pain and pressure algometry were assessed at different timepoints. High-density surface electromyography activity and its spatial distribution were determined for biceps and triceps brachii.ResultsBoth BFR conditions were safe in PWH. AUTO provided a hypotensive and hypoalgesic acute response, albeit without between-group differences. Triceps brachii showed differences in spatial distribution, and greater activity with AUTO in the last 3 cycles of the first 3 sets. Although no major differences were found between both conditions in perceptual responses, AUTO condition increased VAS scores during both exercises. No adverse events were observed.ConclusionsBFR at 50%LOP during arm exercise with either AUTO or NAUTO appears to be equally safe in PWH, but AUTO showed trends for improved cardiovascular and neuromuscular responses. AUTO produced a hypotensive and hypoalgesic acute post-exercise response, albeit without between-group differences, a greater activation in triceps brachii, and higher values of pain. No serious adverse events were observed.
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spelling doaj-art-99e98c4f67ee4e81afec2f525635ad3c2025-08-20T02:46:40ZengFrontiers Media S.A.Frontiers in Sports and Active Living2624-93672025-07-01710.3389/fspor.2025.15876151587615Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophiliaDaniel C. Ogrezeanu0Andrea Tur-Boned1Nicholas Rolnick2Nicholas Rolnick3Juan J. Carrasco4Juan J. Carrasco5Carlos Cruz-Montecinos6Carlos Cruz-Montecinos7Joaquín Calatayud8Santiago Bonanad9Sofía Pérez-Alenda10Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, SpainDepartment of Physiotherapy, University of Valencia, Valencia, SpainThe Human Performance Mechanic, New York, NY, United StatesDepartment of Exercise Sciences and Recreation, Lehman College, Bronx, NY, United StatesPhysiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, SpainIntelligent Data Analysis Laboratory, University of Valencia, Valencia, SpainPhysiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, SpainLaboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, ChileExercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, SpainHaemostasis and Thrombosis Unit, Universitary and Polytechnic Hospital La Fe, Valencia, SpainPhysiotherapy in Motion Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, SpainIntroductionLow-load resistance training with concurrent blood flow restriction (BFR) provides strength and hypertrophy benefits to healthy individuals and some clinical populations. This is the first study assessing safety and physiological responses of autoregulated (AUTO) and non-autoregulated (NAUTO) BFR protocols in people with hemophilia (PWH). Therefore, this study aimed to evaluate the acute safety, cardiovascular, neuromuscular and perceptual responses during AUTO and NAUTO BFR training in PWH.MethodsEleven severe PWH under prophylaxis performed two sessions of elbow flexion and extension using elastic bands at 50% of the limb occlusion pressure (LOP) with different BFR settings (AUTO vs. NAUTO). Safety, cardiovascular parameters, rating of perceived exertion, elbow pain and pressure algometry were assessed at different timepoints. High-density surface electromyography activity and its spatial distribution were determined for biceps and triceps brachii.ResultsBoth BFR conditions were safe in PWH. AUTO provided a hypotensive and hypoalgesic acute response, albeit without between-group differences. Triceps brachii showed differences in spatial distribution, and greater activity with AUTO in the last 3 cycles of the first 3 sets. Although no major differences were found between both conditions in perceptual responses, AUTO condition increased VAS scores during both exercises. No adverse events were observed.ConclusionsBFR at 50%LOP during arm exercise with either AUTO or NAUTO appears to be equally safe in PWH, but AUTO showed trends for improved cardiovascular and neuromuscular responses. AUTO produced a hypotensive and hypoalgesic acute post-exercise response, albeit without between-group differences, a greater activation in triceps brachii, and higher values of pain. No serious adverse events were observed.https://www.frontiersin.org/articles/10.3389/fspor.2025.1587615/fullelectromyographyresistance trainingischemic preconditioninghemarthrosishemophilia A
spellingShingle Daniel C. Ogrezeanu
Andrea Tur-Boned
Nicholas Rolnick
Nicholas Rolnick
Juan J. Carrasco
Juan J. Carrasco
Carlos Cruz-Montecinos
Carlos Cruz-Montecinos
Joaquín Calatayud
Santiago Bonanad
Sofía Pérez-Alenda
Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
Frontiers in Sports and Active Living
electromyography
resistance training
ischemic preconditioning
hemarthrosis
hemophilia A
title Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
title_full Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
title_fullStr Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
title_full_unstemmed Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
title_short Acute safety, cardiovascular, perceptual and neuromuscular responses to autoregulated and non-autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
title_sort acute safety cardiovascular perceptual and neuromuscular responses to autoregulated and non autoregulated blood flow restriction training during elbow rehabilitation in people with hemophilia
topic electromyography
resistance training
ischemic preconditioning
hemarthrosis
hemophilia A
url https://www.frontiersin.org/articles/10.3389/fspor.2025.1587615/full
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