Episode 20: Use of BFR in Sport Rehab and Performance

SHOW OUTLINE

• (1:10) Kyle Kimbrell-  Bio
• (5:26) History and Background about BFR development, physiology, and implementation
  • Julius Conheim- https://www.annclinlabsci.org/content/14/5/335.full.pdf
  • August Bier- https://embryo.asu.edu/pages/august-karl-gustav-bier-1861-1949
  • Alam M, Smirk FH. Observations in man upon a blood pressure raising reflex arising from the voluntary muscles. J Physiol. 1937 Jun 3;89(4):372-83. doi: 10.1113/jphysiol.1937.sp003485. PMID: 16994867; PMCID: PMC1395054.
  • Kaatsu- https://kaatsu.co.uk/kaatsu-history-and-future/#:~:text=Introduction%20of%20the%20KAATSU%20Instructor,Japan%20Manned%20Space%20Systems%20Corporation.
  • Stephen Patterson and Jeremy Loenneke
  • Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol. 2019 May 15;10:533. doi: 10.3389/fphys.2019.00533. Erratum in: Front Physiol. 2019 Oct 22;10:1332. doi: 10.3389/fphys.2019.01332. PMID: 31156448; PMCID: PMC6530612.
  • Johnny Owens- https://www.researchgate.net/profile/Johnny-Owens/publication/335529644_Blood_Flow_Restriction_Therapy_From_Development_to_Applications/links/5d6fcc8f4585151ee49dfae4/Blood-Flow-Restriction-Therapy-From-Development-to-Applications.pdf

• (14:40) Brief overview of the BFR physiology, mechanism for effectiveness, and messaging to patients for education- Fatigue-Failure mechanism.
• (19:07) BFR clinical applications
  • Mitigating muscle atrophy/triggering hypertrophy and strength gains
• (22:12) Ideal timeframe for BFR implementation post-operatively 
  • Franz A, Heiß L, Schlotmann M, Ji S, Strauss AC, Randau T, Fröschen FS. Passive Blood-Flow-Restriction Exercise’s Impact on Muscle Atrophy Post-Total Knee Replacement: A Randomized Trial. J Clin Med. 2025 Jul 23;14(15):5218. doi: 10.3390/jcm14155218. PMID: 40806840; PMCID: PMC12347597.
  • Rationale for early implementation and possible contributor to lack of evidence for BFR efficacy in post-op ACLR research studies
• (30:03) What do you feel is ideal LOP to start at in a post-op knee patient?
• (35:20) BFR application duration for exercise application and reperfusion window
• (38:38) Minimum limb occlusion pressure for benefit
• (41:24) Titrating intensity and load parameters, and progression criteria/guidelines
• (47:40) Ideal sets/reps scheme and origin of traditional programming scheme, and training to at or near failure
• (53:46) Proposed mechanism for benefits on muscles proximal to cuff for post-op hips, shoulders, etc. 
• (62:37) Exercise selection process and considerations with BFR
• (65:40) Other clinical applications for BFR
• (76:00) Ischemic pre-conditioning BFR and recovery process/recovery windows
• (79:00) Next step or the gap in research on BFR use in rehab currently?
• (84:46) Projects or things you have happening professionally in 2026