Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes

Abstract

Blood flow restriction resistance training (BFRT), that is exercising under partial vascular occlusion via inflation cuffs – can induce gains in skeletal muscle mass and strength similar to those seen with classical resistance training, albeit with marked lower training load. Mechanistically, BFRT leads to accumulation of metabolites in myocytes and triggers the recruitment of higher-threshold motoneurons, induces cell swelling, and promotes protein biosynthesis, resulting in increased muscle mass and strength. Furthermore, low myocellular oxygen tension can induce angiogenesis, increase reactive oxygen species (ROS) production, mitochondrial biogenesis, and glucose transporter (GLUT) 4 expression. In addition to impaired glucose metabolism and physical fitness, individuals with type 2 diabetes are at increased risk of sarcopenia. For these individuals, low-load BFRT may be an effective exercise modality. Blood flow restriction resistance training (BFRT) employs partial vascular occlusion of exercising muscles via inflation cuffs. Compared with high-load resistance training, mechanical load is markedly reduced with BFRT, but induces similar gains in muscle mass and strength. BFRT is thus an effective training strategy for people with physical limitations. Recent research indicates that BFRT has beneficial effects on glucose and mitochondrial metabolism. BFRT may therefore qualify as a valuable exercise alternative for individuals with type 2 diabetes (T2D), a disorder characterized by impaired glucose metabolism, musculoskeletal decline, and exacerbated progression of sarcopenia. This review covers the effects of BFRT in healthy populations and in persons with impaired physical fitness, the mechanisms of action of this novel training modality, and possible applications for individuals with T2D.