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1. Patients or post-operative clients, high load and high intensity workouts may not be clinically appropriate. It has been used in the health club setting for some time however it is getting appeal in clinical settings. BFR training was initially established in the 1960's in Japan and understood as KAATSU training. It can be used to either the upper or lower limb. The cuff is then pumped up to a specific pressure with the aim of obtaining partial arterial and total venous occlusion. The patient is then asked to carry out resistance exercises at a low strength of 20-30% of 1 repetition max (1RM), with high repeatings per set (15-30) and brief rest periods in between sets (30 seconds) Understanding the Physiology of Muscle Hypertrophy. [edit edit source] Muscle hypertrophy is the boost in size of the muscle as well as an increase of the protein material within the fibres. Muscle tension and metabolic tension are the 2 primary factors accountable for muscle hypertrophy. The activation of myogenic stem cells and the raised anabolic hormones result in protein metabolism and as such muscle hypertrophy can happen. Growth hormonal agent itself does not directly trigger muscle hypertrophy however it assists muscle recovery and therefore potentially assists in the muscle reinforcing procedure. The build-up of lactate and hydrogen ions (eg in hypoxic training) more increases the release of development hormonal agent. Myostatin controls and hinders cell growth in muscle tissue. Resistance training results in the compression of blood vessels within the muscles being trained. This causes a boost in anaerobic lactic metabolism and the production of lactate. When there is blood pooling and an accumulation of metabolites cell swelling takes place. This swelling within the cells triggers an anabolic reaction and results in muscle hypertrophy. The cell swelling might actually trigger mechanical stress which will then trigger the myogenic stem cells as gone over above. The cuff is positioned proximally to the muscle being workout and low intensity workouts can then be performed. Because the outflow of blood is limited using the cuff capillary blood that has a low oxygen material gathers and there is an increase in protons and lactic acid. The exact same physiological adaptations to the muscle (eg release of hormonal agents, hypoxia and cell swelling) will happen throughout the BFR training and low strength exercise as would take place with high intensity exercise. ( 1) Low intensity BFR (LI-BFR) leads to an increase in the water content of the muscle cells (cell swelling). It likewise accelerates the recruitment of fast-twitch muscle fibers. It is also assumed that as soon as the cuff is gotten rid of a hyperemia (excess of blood in the capillary) will form and this will cause additional cell swelling. These increases resembled gains obtained as a result of high-intensity workout without BFR A study comparing (1) high strength, (2) low strength, (3) low and high intensity with BFR and (4) low strength with BFR. While all 4 exercise programs produced increases in torque, muscle activations and muscle endurance over a 6 week duration - the high strength (group 1) and BFR (groups 3 and 4) produced the greatest result size and were similar to each

2. other.