Tuesday, March 28, 2017

[進修研習] 血液流量限制訓練 Blood Flow Restriction



  最近在聖地牙哥進修了血液流量限制訓練的課程
  同時感受到了物理性與知識性的進步
  下面做一些總結分享
   Recently I went to San Diego for the seminar of blood flow restriction(BFR)
   I improved both physically and mentally.
   Here are some content I'd like to share

  什麼是血液流量限制訓練
  藉由限制血液流量達到低負擔高強度的訓練方式
  What is BFR?
  By limiting blood flow to exercise in low load but high intensity
 


  最早被應用的目標領域是肌力與肌肥大
  肌肉生長有兩個理論必須要理解
  機械張力模型(Mechanical Tension Model)以及代謝壓力(Metabolic stress)
  BFR在研究上可以同時達成兩者
  限制動脈血流造成提早徵召快肌 使Mechanical tension上升
  限制靜脈血流造成回流不能(缺氧, 代謝物無法排除) 使Metabolic stress增加
  The first application for BFR is strength and atrophy
  There are two theory need to be understood:
  Mechanical Tension Model and Metabolic stress
  The researched showed BFR can achieve both in the same time.
  Limiting artery blood flow can cause early engage of fast twitch fiber, increasing mechanical tension
  Limiting venous blood flow can trap return flow, increasing metabolic stress.

  而在Takarada 2000年的回顧裡面
  BFR的肌肉尺寸與肌力相較於低強度訓練(LI)有顯著增加
  跟傳統高強度訓練(HIT)比較起來肌肉橫切面增長差不多, 肌力則是小輸一點
  In the review of Takarada 2000,
  BFR has significant improvement of muscle cross section area(CSA) and strength to LI group
  Between BFR and HIT, the CSA change is similar but the strength is better in HIT group
 
  

  除此之外 限制靜脈血流還有兩個額外效果
  分別是細胞腫脹(Cell swelling)以及減低心輸出量(SV)
  這兩個效果分別對應了BFR在促進蛋白合成以及心肺耐訓練上的應用
  More over, limiting venous blood flow has two extra effect.
  Cell swelling and Stroke Volume decreasing.
  Those two correspond to enhance protein synthesis and increase endurance.

  而在系統性的角度來看
  BFR會促進生長激素的釋放 - 促進膠原蛋白合成
  抑制肌生成抑制素(Myostatin,轉化生長因子β) - 減少組織纖維化
  促進第一類型胰島素生長因子(IGF1) - 修補受損肌肉
  From the systemic view, BFR can:
  facilitating growth hormone release - enhance protein synthesis
  Down regulating Myostatin(TGFβ) - decrease scar tissue formation
  Facilitating IGF1 - repair damage muscle
 
肌生成抑制素缺乏 Myostatin insufficiency
  但是, 由於限制了正常的血流流動
  在沒有精密限制與監督下的訓練是十分危險的事情
  絕對不是拿一條帶子綁綁就可以解決
  BUT, due to the limitation of normal blood flow,
  BFR training without precise pressure and supervision is very dangerous.
  IT IS NOT only wrap yourself with a band.

  現在這門技術越來越受到重視 特別針對術後的復健領域
  更多的研究在未來將會陸續地發表
  我也會持續地為大家更新新的發現與進展

  額外閱讀
  https://www.ncbi.nlm.nih.gov/pubmed/25249278
  https://www.ncbi.nlm.nih.gov/pubmed/19885776

  創用 CC 授權條款
本著作由I-Chen Liu, PT, MS製作,以創用CC 姓名標示-非商業性-相同方式分享 4.0 國際 授權條款釋出。