European journal of applied physiology | 2021
Blood flow restriction in the presence or absence of muscle contractions does not preserve vasculature structure and function following 14-days of limb immobilization.
Abstract
PURPOSE\nLimb immobilization causes local vasculature to experience detrimental adaptations. Simple strategies to increase blood flow (heating, fidgeting) successfully prevent acute (≤\u20091\xa0day) impairments; however, none have leveraged the hyperemic response over prolonged periods (weeks) mirroring injury rehabilitation. Throughout a 14-day unilateral limb immobilization, we sought to preserve vascular structure and responsiveness by repeatedly activating a reactive hyperemic response via blood flow restriction (BFR) and amplifying this stimulus by combining BFR with electric muscle stimulation (EMS).\n\n\nMETHODS\nYoung healthy adults (M:F\u2009=\u200914:17, age\u2009=\u200922.4\u2009±\u20093.7\xa0years) were randomly assigned to control, BFR, or BFR\u2009+\u2009EMS groups. BFR and BFR\u2009+\u2009EMS groups were treated for 30\xa0min twice daily (3\u2009×\u200910\xa0min ischemia-reperfusion cycles; 15% maximal voluntary contraction EMS), 5 days/week (20 total sessions). Before and after immobilization, artery diameter, flow-mediated dilation (FMD) and blood flow measures were collected in the superficial femoral artery (SFA).\n\n\nRESULTS\nFollowing immobilization, there was less retrograde blood velocity (+\u20091.8\u2009±\u20093.6\xa0cm\xa0s-1, P\u2009=\u20090.01), but not retrograde shear (P\u2009=\u20090.097). All groups displayed reduced baseline and peak SFA diameter following immobilization (- 0.46\u2009±\u20090.41\xa0mm and - 0.43\u2009±\u20090.39\xa0mm, P\u2009<\u20090.01); however, there were no differences by group or across time for FMD (% diameter change, shear-corrected, or allometrically scaled) nor microvascular function assessed by peak flow capacity.\n\n\nCONCLUSION\nFollowing immobilization, our results reveal (1) neither BFR nor BFR\u2009+\u2009EMS mitigate artery structure impairments, (2) intervention-induced shear stress did not affect vascular function assessed by FMD, and (3) retrograde blood velocity is reduced at rest offering potential insight to mechanisms of flow regulation. In conclusion, BFR appears insufficient as a treatment strategy for preventing macrovascular dysfunction during limb immobilization.