Applicability of Tissue Flossing for Blood Flow Restriction in the Upper Limb: Reliability and Performance Analysis

Condition(s) studied

Investigational drug(s) / intervention(s)

Tissue Flossing: Tissue Flossing ia a elastic band that when applied exerts an external pressure above or below a muscle or joint of the extremities.

Blood Flow Restriction Cuff: Inflatable device that exerts an external pressure above a muscle or joint of the extremities.

Training Protocol: The upper limb resistance training protocol will follow that recommended in the study by Patterson et al. for resistance training, and will last 15weeks, with 3 training sessions per week, with a day break between sessions.

Study summary

Blood flow restriction (BFR) is a widely studied technique that combines low-intensity exercise with vascular occlusion, resulting in muscular benefits. However, its application is challenging due to methodological variations and equipment costs. Tissue Flossing (TF) appears as an affordable alternative, but lacks solid scientific evidence.

Eligibility

Primary outcome measure(s)

• Occlusion pressures (AOP, 80% and 40% of AOP) — 3 days
  To determine the AOP, the Doppler equipment transducer will be used, which will be positioned over the brachii artery to capture the auscultatory pulse. A blood pressure cuff will be fixed to the participant's thigh close to the region of the inguinal fold of the dominant limb, and then with the inflatable region of the cuff on the medial portion of the thigh covering the femoral artery, it will be progressively inflated, waiting 15 seconds every 30 mmHg until the point at which the auscultatory pulse of the brachii artery is interrupted.
• Assessment of arterial flow and diameter — 3 days
  A Sonoline Sienna® vascular ultrasound will be used combined with a 40mm B-mode ultrasonic transducer with a 7.5 MHz linear beam, which will be coated with gel for acoustic contact and positioned longitudinally to the posterior brachii artery, enabling variables to be assessed. Doppler flow measurements of upper limb (peak systolic velocity \[cm/s\], end-diastolic velocity \[cm/s\] and arterial diameter).
• Perceptual parameter — 3 days
  The perceptual parameter will be evaluated using a Borg CR10+ scale, representing the perception of discomfort, 0 represents no discomfort and 10 extremely uncomfortable.
• Tissue Flossing Assessment — 3 days
  The application of tissue flossing on the leg will be carried out by always passing the elastic tape with 50% of the tape over the next strip, until the end of the elastic tape.
• Weight — 3 days
  It will be collected with a weight balance
• Height — 1 day
  It will be collected with a stadiometer
• Body Fat — 1 day
  It will be collected with a adipometer
• Arterial pressure — 1 day
  It will be collected with a sphygmomanometer
• Perimetry of the dominant upper limb — 1 day
  It will be defined by the Waterloo Footedness
• Limb length — 1 day
  Identified with a measuring tape
• Perceived exertion scale — up to 15 weeks
  Adapted BORG scale, with 0 being "no effort" and 10 "maximum effort".
• Method preference — up to 15 weeks
  Participants must answer a brief questionnaire about their preference for one of the BFR methods carried out, and justify why they chose it.
• 1 Maximum Repetition Test — up to 15 weeks
  The warm-up will include a series of 6 to 10 repetitions, using approximately 50% of the estimated load for the first attempt of the test (44). This warm-up will not only prepare participants but also familiarize them with the movement. The determination of the initial warm-up load will be made subjectively by the researcher responsible for the study, considering the participant's height, body mass and training experience as reference points (45). After the warm-up phase, up to five attempts will be given to find the 1RM, with intervals of 3 to 5 minutes between them (46). The load adjustment for subsequent attempts will be determined by the subjective perception of effort, according to the BORG scale, where the greater the perception of effort, the lower the percentage of load added for the next attempt. The 1RM will be established as the maximum load at which the participant can perform one repetition without compensation.
• Myotonometry — up to 15 weeks
  Myotonometry will be assessed using the MyotonPRO® tool, which consists of a portable, wireless and non-invasive device. The measurement will be carried out once, and in each shot, the following myotonometry parameters will be calculated: the state of tension (tone) and biomechanical properties (rigidity and elasticity).
• Ultrasound — up to 15 weeks
  The assessment of the muscular structure will be carried out using ultrasound images of the participant's upper limbs, which will be captured using BodyMetrix BX-2000. Participants will be assessed in the supine position with arms fully extended and muscles relaxed. The ultrasound transducer will be covered with water-soluble transmission gel and positioned perpendicular to the skin over the muscle.

Trial sites (1)

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