Interventional Medicine & Applied Science, Vol. 5 (2), pp. 53–59 (2013)

O R I G I N A L PA P E R

Effects of low-intensity concentric and eccentric exercise combined with blood flow restriction on indices of exercise-induced muscle damage ROBERT S. THIEBAUD1*, TOMOHIRO YASUDA2, JEREMY P. LOENNEKE1, TAKASHI ABE3 1

Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA Department of Ischemic Circulatory Physiology, The University of Tokyo, Tokyo, Japan 3 Department of Health, Exercise Sciences & Recreation Management, University of Mississippi, Oxford, MS, USA *Corresponding author: Robert S. Thiebaud; Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave., Norman, OK 73019, USA; Phone: +1-405-325-5211; Fax: +1-405-325-0594; E-mail: [email protected] 2

(Received: December 24, 2012; Revised manuscript submitted: March 4, 2013; Accepted: March 5, 2013) Abstract: Low-intensity blood-flow restriction (BFR) resistance training significantly increases strength and muscle size, but some studies report it produces exercise-induced muscle damage (EIMD) in the lower body after exercise to failure. Purpose: To investigate the effects of a pre-set number of repetitions of upper body concentric and eccentric exercise when combined with BFR on changes in EIMD. Methods: Ten young men had arms randomly assigned to either concentric BFR (CON-BFR) or eccentric BFR (ECC-BFR) dumbbell curl exercise (30% one-repetition maximum (1-RM), 1 set of 30 repetitions followed by 3 sets of 15 repetitions). Maximal isometric voluntary contraction force (MVC), muscle thickness (MTH), circumference, range of motion (ROM), ratings of perceived exertion (RPE), and muscle soreness were measured before, immediately after, and daily for 4 days post-exercise. Results: MVC decreased by 36% for CON-BFR and 12% for ECCBFR immediately after exercise but was not changed 1–4 days post-exercise (p > 0.05). Only CON-BFR had significant changes in MTH and circumference immediately after exercise (p < 0.05). Muscle soreness was observed in the ECC-BFR arm at 1 and 2 days after exercise. Conclusions: Low-intensity ECC-BFR produces significant muscle soreness at 24 h but neither ECC-BFR nor CON-BFR exercise produces significant changes in multiple indices of EIMD. Keywords: delayed onset muscle soreness, blood flow restriction, ultrasound, muscle damage, lengthening contractions

Introduction

individual muscle fibers resulting in greater EIMD [1]. Therefore, little EIMD is produced from low-intensity eccentric resistance exercise [8]. Interestingly, some studies have reported that EIMD is produced when low-intensity resistance exercise is combined with blood flow restriction (BFR) and that concentric exercise with BFR produces greater EIMD than eccentric exercise with BFR [9, 10]. However, it has also been noted that low-intensity BFR does not result in decreases in force production or increases in creatine kinase, which are indirect markers of EIMD [11, 12]. Blood flow restriction involves placing a cuff around the exercising limb and then applying pressure to produce venous pooling. When combined with low-intensity exercise (≤30% 1-repetition maximum [1-RM]), BFR results in comparable changes in strength and muscle hypertrophy to that observed with higher-intensity re-

Exercise-induced muscle damage (EIMD) is a wellknown phenomenon first noted in the early 1900s and continues to be a topic of interest [1]. Indices of EIMD include swelling of the exercised limb, decreased range of motion (ROM), increased creatine kinase and myoglobin levels in the blood, decreased force production, and delayed-onset muscle soreness (DOMS) [2]. The severity of EIMD is related to the type [3] and intensity [4] of exercise. It is well established in the literature that eccentric exercise induces EIMD [5, 6], while concentric exercise does not seem to produce substantial levels of EIMD [7]. Furthermore, as exercise intensity increases, EIMD increases [4]. As the amount of specific force on the muscle fibers increases with increasing exercise intensity, more mechanical strain is placed on the

DOI: 10.1556/IMAS.5.2013.2.1

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Exercise protocol

sistance exercise [13]. This type of exercise may be beneficial for older populations, individuals with muscular diseases, or in individuals going through rehabilitation who cannot lift sufficiently high loads to increase muscle size and strength. However, if this type of exercise produces significant EIMD during low-intensity resistance exercise, it may not be recommended for some populations who are more susceptible to muscle damage. Thus, it is important to clarify if this type of exercise produces significant EIMD and to verify if concentric exercise produces higher levels of EIMD compared to eccentric exercise. The various findings of EIMD and BFR may be partially due to differences in work performed during BFR exercise. When EIMD is reported with BFR, the repetitions have been performed to failure in the knee extensors [9, 10], while those not reporting EIMD use a submaximal protocol (pre-set number of repetitions or walking) [11, 12]. However, many of the subjects in the study by Loenneke et al. [12] were unable to reach the goal set of repetitions in the final two sets. All of these studies have examined the effects of BFR on EIMD in the lower body, but none have investigated the effects of BFR on EIMD in the upper body. If EIMD were produced in the lower body with BFR, it would be important to note BFR’s effects on EIMD in the upper body, which is more susceptible to EIMD than the lower body [14]. Therefore, the purpose of this study was to investigate the effects of a pre-set number of repetitions of low-intensity (30% 1-RM) eccentric BFR (ECC-BFR) or concentric BFR (CON-BFR) exercise on EIMD in the upper body. We hypothesized that due to a low intensity and low volume of exercise with BFR using a pre-set number of repetitions, little EIMD would be produced in either the ECC-BFR or CON-BFR condition in the upper body.

One week before the investigation, the concentric 1-RM for each arm was determined. The week prior to 1-RM testing, subjects were familiarized with the biceps curl and 1-RM testing procedure. For the 1-RM test, subjects performed five to six unilateral biceps curls (dumbbells) with a low load (approximately 30–40% predicted 1-RM) as a warm-up and to familiarize subjects with the biceps curl exercise. After warming up, the load was set at ~80% of the predicted 1-RM. Following each successful lift (the investigator took the dumbbell at the top of the movement so that only the concentric action was performed), the load was increased by ~5% until the subject failed to lift the load through the entire range of motion. A test was considered valid if the subject used proper form and completed the entire lift in a controlled manner without assistance. On average, five trials were required to complete a 1-RM test (2–3 min rest between each attempt). The average 30% 1-RM dumbbell weight used during exercise for the non-dominant arm was 3.1 ± 0.5 kg and for the dominant arm was 3.5 ± 0.6 kg. For the exercise session, the exercise intensity was set at 30% 1-RM for each arm, respectively. Subjects performed four sets of bicep curls (using dumbbells) with BFR with the first set consisting of 30 repetitions and the next three sets consisting of 15 repetitions each for a total of 75 repetitions [15, 16]. Subjects rested for 30 s between each set. One arm was randomly chosen to perform CON-BFR exercise while the other arm performed ECC-BFR. The arms were counterbalanced such that the CON-BFR and ECC-BFR condition each included five dominant and five non-dominant arms. After performing either the CON-BFR or ECC-BFR condition first, the other condition was performed. Both conditions were completed on the same day with approximately 10 min of rest between exercise bouts. During these protocols, the subjects performed their respective action with a cadence of 1.5 s for concentric (shortening) or 1.5 s for eccentric (lengthening) using a metronome, and the investigators manually performed the opposite muscle action. Subjects were in the standing position during each exercise. Elbow joint range of motion (ROM) during exercise was completed from full extension to full flexion.

Materials and Methods Subjects Ten young men (age 23 ± 2 years; height 168.7 ± 3.1 cm; weight 60.1 ± 4.3 kg; systolic blood pressure 112 ± 10 mm Hg; diastolic blood pressure 67 ± 10 mm Hg), who had not performed regular resistance training or sports activities for at least the previous year, volunteered to participate in this study. The subjects were recruited by word of mouth from the university campus and were free of muscle, joint, and/or bone injuries of the upper extremities. All subjects were informed of the methods, procedures, risks, and signed an informed consent document before participating in the study. The study was conducted according to the Declaration of Helsinki and was approved by the Ethics Committee for Human Experiments of the University of Tokyo, Japan.

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Blood flow restriction A method for inducing the moderate occlusion of blood flow has previously been reported [17]. A specially designed elastic pressure cuff (30 mm wide, KAATSU Master, Sato Sports Plaza, Tokyo, Japan) was used. The pressure cuff was placed around the most proximal portion of the upper arm. The initial pressure of the cuff was set to 30 mm Hg (pressure applied to limb prior to infla-

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tion). The cuff was inflated to 60 mm Hg and gradually inflated and deflated until a final pressure of 120 mm Hg was reached. The cuff remained inflated until immediately after the exercise bout when the pressure was released, and the cuff was quickly removed. The amount of time under moderate blood flow restriction was approximately 5 min.

3, and 4 days post-exercise)]. If a significant group or group × time effect was observed then a paired sample t-test was done to determine differences between groups at each time point and a one-way ANOVA followed by pairwise comparisons using the Bonferroni adjustment was used to detect differences among conditions at each time point. Statistical significance was set at p < 0.05.

Measurements

Results

Maximal isometric force of the elbow flexors, circumference of the upper arm, ROM of the elbow joint, muscle thickness (MTH) of the elbow flexors, and muscle soreness were measured before, immediately after (without cuff), and daily for 4 days after the exercise bout of each arm. Each subject was measured at the same time of day throughout the investigation. Maximum voluntary isometric contraction (MVC) torque was measured twice by a dynamometer (Taiyo Kogyo Co., Tokyo, Japan) at an elbow joint angle of 90° for 3 s, and the mean value was used. A goniometer measured the relaxed and flexed elbow joint angles. Range of motion (ROM) was calculated by subtracting the flexed angle from the relaxed angle. Circumferences on the upper arm at 10 cm from the elbow joint and at mid-upper arm were measured by a tape measure (Model R-280, Futaba, Japan) when letting the arm hang down by the side. B-mode ultrasound with 10 MHz probe (Acuson Sequoia 512; Siemens, Tokyo, Japan) was used to obtain the transverse images of the elbow flexors at same sites of the circumference measurements [18]. The subcutaneous adipose tissue-muscle interface and the muscle-bone interface were identified from the ultrasonic image, and the distance between two interfaces was recorded as MTH. A visual analog scale (VAS) that had a 100-mm line with 0 mm indicating “no pain” and 100 mm indicating “extremely sore” was used to quantify soreness levels. The subject was instructed to mark a point on the line describing their soreness after they palpated their upper arm with their fingers (palpated ~5 mm skin indention), while the investigator passively extended and flexed the subject’s forearm. The highest value of soreness from these three methods for each subject was used for muscle soreness analysis. Borg’s Rating of Perceived Exertion (RPE), which is a scale (6–20) to measure subjective feelings of exertion and fatigue, was recorded immediately after each set of the exercise bout [19].

When examining changes in muscle soreness, the CONBFR did not significantly increase over time with the highest value reaching 4 (5) mm at 1 day post-exercise. In the ECC-BFR, muscle soreness significantly increased

Fig. 1.

Muscle soreness changes. Change in muscle soreness before and 1–4 days after low-intensity eccentric (ECC) and concentric (CON) exercise combined with blood flow restriction. Error bars represent standard deviation. *Significant difference from pre-exercise, p < 0.05. †Significant difference between groups, p < 0.05

Fig. 2.

Maximal voluntary isometric contraction torque (MVC) percent changes. Percent change in MVC after low-intensity eccentric (ECC) and concentric (CON) exercise combined with blood flow restriction. Error bars represent standard deviation. *Significant difference from preexercise, p < 0.05. †Significant difference between groups, p < 0.05

Statistical analysis All data were analyzed using a SPSS v. 17.0 for Windows (SPSS Inc., Chicago, IL), and results are expressed as means ± standard deviation for all variables. Statistical analysis was performed by a two-way ANOVA with repeated measures [trials (Concentric and Eccentric)  ×  time (before, immediately post-exercise, 1, 2,

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to 20 (11) mm at 24 h and 15 (10) mm at 48 h but was not significant at 3 days post-exercise, 9 (9) mm (Fig. 1). A significant difference in muscle soreness between the ECC-BFR and CON-BFR was found at day 1 (20 mm vs. 4 mm), day 2 (15 mm vs. 3 mm), and day 3 (9 mm vs. 0 mm) (Fig. 1). Maximum voluntary contraction (MVC) significantly decreased post-exercise for both conditions but the CON-BFR had a significantly greater decline in %MVC compared to the ECC-BFR (64% vs. 88%) (Fig. 2). However, MVC values were not statistically different from baseline values at 1, 2, 3, and 4 days post-exercise in both conditions (Table 1). ROM decreased and MTH at 10 cm increased in both the ECC-BFR and CON-BFR immediately post-

exercise and returned to baseline levels at 1 day postexercise (Table 1). A significantly larger increase in the CON-BFR was found compared to the ECC-BFR immediately post-exercise for MTH at 50% (3.0 cm vs. 2.7 cm), MTH at 10 cm (3.6 cm vs. 3.4 cm), and circumference at 10 cm (26.8 cm vs. 26.0 cm) (Table 1). However, ROM, MTH at 50%, MTH at 10 cm, circumference at 50%, circumference at 10 cm were not significantly different from pre-exercise values at days 1, 2, 3, or 4 days for either condition (Table 1). The RPE values during exercise were significantly greater during the CON-BFR at each set compared to the ECC-BFR: Set 1 (14 ± 1 vs. 11 ± 2), Set 2 (15 ± 2 vs. 12 ± 2), Set 3 (17 ± 2 vs. 12 ± 2), and Set 4 (18 ± 2 vs. 13 ± 2).

Indirect exercise-induced muscle damage markers

Table I

Muscle action  

Time (days) Pre

Post

1

2

3

4

ECC

37.2 ± 4.7

32.9 ± 4.7*

35.8 ± 5.2

35.8 ± 5.4

36.7 ± 5.7

36.9 ± 5.3

CON

37.6 ± 4.7

24.2 ± 5.2*†

37.4 ± 4.4

37.0 ± 4.1

37.2 ± 4.4

37.5 ± 5.1

MVC (Nm)

ROM (°) ECC

130 ± 8

124 ± 10*

129 ± 8

130 ± 7

127 ± 10

130 ± 7

CON

129 ± 8

121 ± 8*

129 ± 9

131 ± 8

129 ± 9

129 ± 9

ECC

2.6 ± 0.2

2.7 ± 0.2

2.6 ± 0.2

2.6 ± 0.2

2.6 ± 0.2

2.6 ± 0.2

CON

2.6 ± 0.3

3.0 ± 0.3*†

2.7 ± 0.3

2.7 ± 0.3

2.7 ± 0.2

2.6 ± 0.3

ECC

3.2 ± 0.2

3.4 ± 0.2*

3.3 ± 0.2

3.3 ± 0.2

3.3 ± 0.2

3.2 ± 0.2

CON

3.2 ± 0.3

3.6 ± 0.3*†

3.3 ± 0.3

3.3 ± 0.3

3.2 ± 0.3

3.2 ± 0.3

Muscle thickness at 50% (cm)

Muscle thickness at 10 cm (cm)

Circumference at 50% (cm) ECC

27.7 ± 1.7

27.9 ± 1.7

27.7 ± 1.9

27.7 ± 1.9

27.6 ± 1.9

27.6 ± 1.7

CON

27.8 ± 2.1

28.5 ± 2.1*

27.8 ± 2.3

27.9 ± 2.2

27.8 ± 2.3

27.8 ± 2.3

ECC

25.7 ± 1.4

26.0 ± 1.5

25.7 ± 1.4

25.7 ± 1.4

25.8 ± 1.4

25.8 ± 1.4

CON

25.8 ± 1.8

26.8 ± 1.7*†

26.0 ± 1.8

25.9± 1.9

25.9 ± 1.8

25.9 ± 1.8

Circumference at 10 cm (cm)

Changes in maximum voluntary contraction (MVC), range of motion (ROM), muscle thickness, and arm circumference after low-intensity eccentric and concentric exercise combined with blood flow restriction. *Significant difference from pre-exercise, p < 0.05. †Significant difference between groups, p < 0.05

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of EIMD) returned to baseline levels within 1 day following both the low-intensity ECC-BFR and CON-BFR exercise. Because all of these markers returned to baseline levels within 1 day, substantial EIMD may not be occurring with low-intensity upper body BFR exercise. In fact, prolonged declines in force production are one of the most valid and reliable indirect markers of EIMD [20], and the lack of prolonged force declines suggests that EIMD was not likely occurring during this type of exercise. It has also been noted that soreness levels do not correlate well with other indices of EIMD. One study found that after performing 16, 24, or 60 maximal lengthening contractions that muscle soreness levels were not different between the number of contractions despite significant differences in other markers of EIMD [21]. Therefore, measuring multiple indices of EIMD is important to clarify if EIMD is occurring and to determine the severity of EIMD. Because multiple indices of EIMD were not significantly worse following either exercise condition, the exercise intensity with BFR may not have been high enough nor lasted long enough to induce significant EIMD. Despite a lack of changes in many indices of EIMD, low-intensity ECC-BFR exercise had peak soreness levels of 20 mm at 1 day post-exercise. Currently, no studies have analyzed muscle soreness associated with BFR resistance exercise in the upper body. Reported muscle soreness in BFR exercise studies have ranged from 33 to 55 mm (VAS, 0–100 mm), following both eccentric and concentric exercise to failure [22, 23] but have also been found to be as low as 1.6 on a verbal analog scale (0–10) after only performing ECC-BFR exercise to failure [9]. The muscle soreness levels in this BFR study were smaller than most other BFR studies (20 mm vs. 33–55 mm). Typically without BFR, low-intensity eccentric exercise (10% MVC) produces non-significant muscle soreness levels [25], but moderate eccentric exercise (40% MVC) produces soreness levels varying from 20 to 30 mm [4]. Our findings of 20 mm agree with the lower levels of muscle soreness found when 30 eccentric repetitions (40% MVC) are performed without BFR [4]. The variation in soreness levels after BFR exercise in different studies may be due to differences in the muscles used (knee flexors vs. elbow flexors), differences in blood pressure cuff sizes used (wide vs. narrow), exercise protocols (pre-set number of repetitions vs. exercise to failure), or differing soreness scales (VAS vs. verbal analog scale). Therefore, when prescribing this type of exercise, it is very important to consider the methodology. A preset number of repetitions using a low-intensity resistance exercise produces low levels of soreness but no other indicators of EIMD. However, one limitation of this study was that we did not examine the differences between non-BFR eccentric exercise and eccentric exercise with BFR nor non-BFR concentric exercise and concentric exercise with BFR.

Discussion When performing a pre-set number of repetitions using low-intensity CON-BFR or ECC-BFR exercise, three main findings are observed. First, low-intensity CON-BFR exercise does not produce significant muscle soreness despite higher RPE during exercise and a decrease in post-exercise MVC (36%). Second, indices of EIMD such as muscle thickness, circumference, MVC, and ROM returned to baseline levels within 1 day following both CON-BFR and ECC-BFR exercise. Third, low-intensity ECC-BFR exercise produced peak muscle soreness at 1 day post-exercise. The finding that low-intensity CON-BFR exercise does not produce significant levels of muscle soreness despite high RPE levels during exercise and decreased MVC levels post-exercise is interesting to note because one study using BFR exercise has shown the opposite. For instance, Umbel et al. [9] had subjects perform CON-BFR leg exercise (35% MVC) to failure for an average of 136 repetitions. The authors found that CONBFR exercise produced significant levels of muscle soreness at 24 and 48 h post-exercise. Furthermore, MVC levels remained significantly decreased from baseline until 48 h post-exercise [9]. This is contrary to the current findings that found no significant levels of muscle soreness after CON-BFR exercise. In addition, MVC levels returned to baseline levels within 1 day and remained there at 2, 3, and 4 days post-exercise. This is important because prolonged decreases in force are one of the best markers of muscle damage [20]. Furthermore, the upper body is more susceptible to muscle damage than the legs [14], but BFR had little effect on muscle soreness, MVC, or other markers of EIMD in the CON-BFR arm. Several differences may explain why the CON-BFR condition did not have significantly greater EIMD compared to the ECC-BFR condition as observed by Umbel et al. [9]. The current study utilized a pre-set number of repetitions (75 repetitions total), while the study by Umbel et al. [9] used repetitions to failure (136 repetitions total). In addition, in the current study, subjects were under BFR for a shorter period of time (5 min vs. 12 min). Another difference may be due to the methodological differences in the ratings of soreness. For example, Umbel et al. [9] had subjects retrospectively rate muscle soreness. In contrast, we had subjects rate their soreness when the subject’s finger palpated their upper arm, while the investigator passively extended and flexed the forearm during each visit. Despite the differences in designs, our findings agree with typical results in the literature which find that concentric exercise does not produce significant levels of EIMD [7]. When examining indices of EIMD in both conditions, little indication of EIMD was found. For instance arm circumference, MTH, MVC, and ROM (all indices

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The most likely reason for the significant amount of muscle soreness observed during low-intensity ECCBFR exercise is due to the eccentric action itself. During eccentric actions, fewer muscle fibers are recruited resulting in greater tension at the myotendinous junction [25]. The lengthening of the sarcomeres and the increased tension produces damage to the muscle architecture [26, 27]. Previous studies using elbow flexors report lower muscle activation in the brachialis compared to the biceps brachii during eccentric exercise [28] which could lead to more muscle damage in the brachialis. In the present study, ECC-BFR exercise induced changes in MTH and circumference were found at 10 cm above the elbow joint, but not at mid-upper arm, suggesting the brachialis muscle may have some damage after ECCBFR exercise. A cascade of events may occur after the eccentric exercise which could include increased amounts of calcium proteolytic enzymes [5], increased inflammation/edema [29], or increased ROS levels [30] and thus increase the sensitivity of the Types III and IV afferent nerve fibers producing an increased sensation of muscle soreness. More research is needed to investigate if these mechanisms may explain the muscle soreness found with low-intensity ECC-BFR exercise. In conclusion, the current findings are different from previous studies investigating EIMD and BFR resistance exercise and implicate that low-intensity CON-BFR resistance exercise using a pre-set number of repetitions in the upper body does not produce significant changes in circumference, muscle thickness, MVC, ROM, or muscle soreness at 1–4 days post-exercise. Even with a lowintensity, however, some soreness is found in the ECCBFR condition despite no other changes in indices of EIMD. Therefore, soreness levels reported during BFR exercise are most likely due to the eccentric action of the exercise and not the concentric action when resistance exercise is not performed to failure in the upper body. Thus, healthy individuals can perform low-intensity BFR upper body resistance training without a concern for producing major indices of muscle damage.

Conflict of Interest Statement The authors declare no conflict of interest.

References 1. Thiebaud RS: Exercise-induced muscle damage: is it detrimental or beneficial? J Trainol 1, 36–44 (2012) 2. Nosaka K, Aldayel A, Jubeau M, Chen TC: Muscle damage induced by electrical stimulation. Eur J Appl Physiol 111, 2427– 2437 (2011) 3. Jones DA, Newham DJ, Torgan C: Mechanical influences on long-lasting human muscle fatigue and delayed-onset pain. J Physiol 412, 415–427 (1989) 4. Chen TC, Nosaka K, Sacco P: Intensity of eccentric exercise, shift of optimum angle, and the magnitude of repeated-bout effect. J Appl Physiol 102, 992–999 (2007) 5. Armstrong RB: Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med Sci Sports Exerc 16, 529– 538 (1984) 6. Clarkson PM, Hubal MJ: Exercise-induced muscle damage in humans. Am J Phys Med Rehabil 81, S52–S69 (2002) 7. Friden J, Sfakianos PN, Hargens AR: Muscle soreness and intramuscular fluid pressure: comparison between eccentric and concentric load. J Appl Physiol 61, 2175–2179 (1986) 8. Lavender AP, Nosaka K: A light load eccentric exercise confers protection against a subsequent bout of more demanding eccentric exercise. J Sci Med Sport 11, 291–298 (2008) 9. Umbel JD, Hoff man RL, Dearth DJ, Chleboun GS, Manini TM, Clark BC: Delayed-onset muscle soreness induced by lowload blood flow-restricted exercise. Eur J Appl Physiol 107, 687– 695 (2009) 10. Wernbom M, Paulsen G, Nilsen TS, Hisdal J, Raastad T: Contractile function and sarcolemmal permeability after acute lowload resistance exercise with blood flow restriction. Eur J Appl Physiol 112, 2051–2063 (2012) 11. Abe T, Kearns CF, Sato Y: Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol 100, 1460– 1466 (2006) 12. Loenneke JP, Thiebaud RS, Fahs CA, Rossow LM, Abe T, Bemben MG: Blood flow restriction does not result in prolonged decrements in torque. Eur J Appl Physiol 113, 923–931 (2013) 13. Loenneke JP, Wilson JM, Marin PJ, Zourdos MC, Bemben MG: Low intensity blood flow restriction training: a meta-analysis. Eur J Appl Physiol 112, 1849–1859 (2012) 14. Chen TC, Lin KY, Chen HL, Lin MJ, Nosaka K: Comparison in eccentric exercise-induced muscle damage among four limb muscles. Eur J Appl Physiol 111, 211–223 (2011) 15. Fahs CA, Rossow LM, Seo DI, Loenneke JP, Sherk VD, Kim E, Bemben DA, Bemben MG: Effect of different types of resistance exercise on arterial compliance and calf blood flow. Eur J Appl Physiol 111, 2969–2975 (2011) 16. Yasuda T, Fujita S, Ogasawara R, Sato Y, Abe T: Effects of lowintensity bench press training with restricted arm muscle blood flow on chest muscle hypertrophy: a pilot study. Clin Physiol Funct Imaging 30, 338–343 (2010) 17. Yasuda T, Brechue WF, Fujita T, Shirakawa J, Sato Y, Abe T: Muscle activation during low-intensity muscle contractions with restricted blood flow. J Sports Sci 27, 479–489 (2009) 18. Abe T, Kondo M, Kawakami Y, Fukunaga T: Prediction equations for body composition of Japanese adults by B-mode ultrasound. Am J Hum Biol 6, 161–170 (1994) 19. Borg GA: Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14, 377–381 (1982)

Acknowledgements The authors thank all of the subjects for their time and efforts, Dr. Toshiaki Nakajima, MD, University of Tokyo, for his medical support, and Dr. Ken Nosaka, Edith Cowan University, for his helpful comments and suggestions for the development of the manuscript. This study was supported, in part, by Grant-in-aid (#23700713 to TY) from the Japan Ministry of Education, Culture, Sports, Science, and Technology.

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20. Warren GL, Lowe DA, Armstrong RB: Measurement tools used in the study of eccentric contraction-induced injury. Sports Med 27, 43–59 (1999) 21. Nosaka K, Newton M, Sacco P: Delayed-onset muscle soreness does not reflect the magnitude of eccentric exercise-induced muscle damage. Scand J Med Sci Sports 12, 337–346 (2002) 22. Wernbom M, Augustsson J, Thomee R: Effects of vascular occlusion on muscular endurance in dynamic knee extension exercise at different submaximal loads. J Strength Cond Res 20, 372–377 (2006) 23. Wernbom M, Jarrebring R, Andreasson MA, Augustsson J: Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load. J Strength Cond Res 23, 2389–2395 (2009) 24. Chen HL, Nosaka K, Chen TC: Muscle damage protection by low-intensity eccentric contractions remains for 2 weeks but not 3 weeks. Eur J Appl Physiol 112, 555–565 (2012) 25. Noonan TJ, Garrett WE, Jr.: Injuries at the myotendinous junction. Clin Sports Med 11, 783–806 (1992)

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26. Lauritzen F, Paulsen G, Raastad T, Bergersen LH, Owe SG: Gross ultrastructural changes and necrotic fiber segments in elbow flexor muscles after maximal voluntary eccentric action in humans. J Appl Physiol 107, 1923–1934 (2009) 27. Newham DJ, McPhail G, Mills KR, Edwards RH: Ultrastructural changes after concentric and eccentric contractions of human muscle. J Neurol Sci 61, 109–122 (1983) 28. Nakazawa K, Kawakami Y, Fukunaga T, Yano H, Miyashita M: Differences in activation patterns in elbow flexor muscles during isometric, concentric and eccentric contractions. Eur J Appl Physiol Occup Physiol 66, 214–220 (1993) 29. MacIntyre DL, Reid WD, McKenzie DC: Delayed muscle soreness. The inflammatory response to muscle injury and its clinical implications. Sports Med 20, 24–40 (1995) 30. Close GL, Ashton T, McArdle A, Maclaren DP: The emerging role of free radicals in delayed onset muscle soreness and contraction-induced muscle injury. Comp Biochem Physiol A Mol Integr Physiol 142, 257–266 (2005)

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Effects of low-intensity concentric and eccentric exercise combined with blood flow restriction on indices of exercise-induced muscle damage.

Low-intensity blood-flow restriction (BFR) resistance training significantly increases strength and muscle size, but some studies report it produces e...
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