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It is the ultimate biohack, but is BFR in adolescents a good idea?
Devin Kielur DAT, LAT, ATC joins Kyle Kimbrell PT, MPT to discuss procedures, protocols, outcome measures…not just hey this is cool…
Blood Flow Restriction: What contraindications are there?
It is like a hybrid car – there are two ways two produce energy for movement
With BFR you are limiting the ability to produce aerobic energy.
Too much load can be problematic post-surgery
Open wounds – no BFR
- With any clotting issues, there should be a doctors clearance
- Post-op is the target time
- The first teaching was: wait until the wound was closed
- With use, there has been less concern with waiting until the wound was closed.
Who is administering it?
What methodology? – you need to have the means to measure the pressure
Do you need it at all?
- Encourage the behavior of “Is this going to outweigh the risk?”
Athletes that do not like having their BP taken.
Sickle cell and diabetes could cause problems.
ORS has trained over 8,000 people in the US alone.
What is the main goal or purpose in using it?
Devin likes to focus on good sleep, nutrition, hydration, and body awareness.
How do you decide what load is used?
We use an RPE scale
Then use our rep scheme and by the end of the exercise, we need you to be exhausted.
We found the analgesic side very beneficial – the cuffs seem to settle the pain down
- Tissue flossing produces a similar effect on the ischemic area and reduces pain…but it should not be counted as occlusion training
Do these goals change in adolescents?
Limit muscle atrophy
Repeated inflation and deflations of the cuffs change the hydration of the cell and trick the body into “feeling normal”
- This would need to occur frequently
Cuffs allow for movement and walking.
This allows PTs to space out the sessions
“I do not want to make your pain worse, but do not tell me your pain.”
I do not tell them what number I am looking for.
They give me the number they feel fits
30/15/15/15 rep scheme with 30-second intervals
***use the patient as the guide***
Initial BFR goal: I want them to be mesmerized by it.
This means I have set the load up and it seems really low at first.
We need a continual push for growth to occur
What procedures or policies would you recommend before beginning to use it.
- Measure LOC
- Prescribe pressure based on that number
- Some companies have not
- Document the number for full occlusion
- Document the pressure for each session
- Document the length of time the cuff was on
- Document the load used
- interventions should be supervised with the AT
Consider the timing of using the devices.
We are basically lifting heavy so plan with the fatigue levels of the day.
What is the variability of using the device between clinicians?
Experience can play a role in the use of BFR.
- This is about equal parts perceived and real
- Confidence and comfort are kinda contagious
Have I done enough? – did they complete the 75 reps 2x in a row? Then I need to increase
How is the person moving?
Are they really sore?
What are they reporting about the interventions?
Kyle takes girth measurements – within a month I should see some increase in girth size. This allows me to check their attendance and level of exertion
We also use this to discuss nutrition and protein intake.
Watch BFR in Adolescents on Facebook
Kyle – firstname.lastname@example.org
Devin: Twitter: @kielur_devin
Jeremy Jackson – MrJeremyJackson on Twitter and Facebook
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