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Blood flow restricted walking: does the hypoxic environment compromise walking technique?
Journal article   Open access   Peer reviewed

Blood flow restricted walking: does the hypoxic environment compromise walking technique?

Thomas Walden, Nathan Smith, Alasdair Dempsey, Andrew Michael Jonson and Olivier Girard
Frontiers in sports and active living, Vol.6, 1481315
2025
PMID: 39850868
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Published 5.03 MBDownloadView
Published (Version of Record)CC BY V4.0 Open Access

Abstract

blood flow restricted exercise walking fatigue kinematics blood flow restriction (BFR)
Introduction Implementing blood flow restriction (BFR) during walking is gaining momentum, with a benefit of this approach being reduced absolute external training intensity, still resulting in chronic adaptations to aerobic fitness (1) and muscular strength (2). BFR-walking leads to acute systemic and local physiological adjustments (3, 4). Systemically, hemodynamic stability is reduced, decreasing venous return, cardiac preload, and stroke volume (5). To compensate, heart rate increases to maintain cardiac output (6) while minute ventilation simultaneously increases as the demand for oxygen rises (2). Locally, reductions in oxygen delivery and removal of metabolic waste create a localized hypoxic environment, lowering muscular pH (3). Consequently, BFR-walking is considered a suitable exercise for load-compromised individuals such as older adults, injured athletes, and patients with chronic musculoskeletal disorders (7). Literature outside of BFR research indicates acidic environments impair muscle contractility and/or develop a sub-optimal shortening velocity, reducing the power output of muscular contractions (8). Prolonged exposure to the localized hypoxic environment could disturb the contractility of leg muscles during walking. Of particular concern is the reduced contractility of the plantar-flexors, the predominant power generators walking (9). Altered submaximal contractibility of the plantar-flexors could cause neuro-mechanical compensatory strategies and redistribute a portion of the mechanical force created at the ankle to the hip and knee to maintain walking speed (10). To accommodate the redistribution of power, changes in spatio-temporal and/or kinematic characteristics would occur (10). Therefore, we intend to discuss how applying BFR may modify critical characteristics of one's natural gait cycle (Figure 1).

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