結合低強度阻力訓練與加壓訓練對肌肉適能的效益及生理機制之探討

The Benefits and Physiological Mechanisms of Low Intensity Resistance Training Combined with Occlusion Training on Muscle Fitness

10.6127/JEPF.2013.17.01

童亢(Kang Tung)；林信甫(Hsin-Fu Lin)；王鶴森(Ho-Seng Wang)

局部缺血 ； 代謝壓力 ； 生長激素 ； ischemia ； metabolic stress ； growth hormone

運動生理暨體能學報

17輯（2013 / 12 / 01）

1 - 16

繁體中文

研究背景：加壓訓練係用充氣式脈壓帶加壓於運動肢段近端以局部限制血流進行訓練。目前研究證實短期低強度阻力訓練（20－50% 1 RM）配合加壓訓練可以促進肌肉肥大及增加肌力，效果與高強度阻力訓練類似。目的：探討阻力訓練結合加壓訓練促進肌肉肥大及增加肌力的可能機制。結語：加壓訓練促進肌肉肥大及肌力可能的途徑，包括：一、缺氧狀態下額外招募快縮肌纖維；二、肌肉內代謝壓力上升刺激生長激素的釋放；三、肌肉內蛋白質合成路徑的活性增加；四、熱衰竭蛋白與神經性一氧化氮合成酶^(-1)活性增加；五、肌肉生長抑制素濃度降低等。除了反覆次數、組數、休息時間與訓練頻率外，不同加壓壓力會對生理反應產生不一樣的變化。未來可朝理想的加壓壓力與持續時間等不同組合，以及潛在的生理機制進行深入的探討。

Background: Occlusion training partially arrests blood-flow to the exercising limb by using a pneumatic tourniquet. At present, many studies showed that the short-term low-intensity resistance training (20-50% 1 RM) combined with occlusion training (LROT) induced muscle hypertrophy and increased strength to the extent equivalent to high-intensity resistance training. Purpose: To review the possible mechanisms for LROT to increase muscle hypertrophy and strength. Summary: There are several possible pathways, including (1) additional recruitment of type II fibers in a hypoxic condition; (2) the increase in intramuscular metabolic stress substances stimulating growth hormone release; (3) activation of intramuscular protein synthesis pathway; (4) heat shock proteins upregulation and increase in Nitric oxide synthase^(-1) activity, and (5) decrease of Myostatin. In addition to repetitions, sets, rest periods and frequency of training, different occlusion pressure and duration would elicit different physiological responses. Future studies are needed to explore potential mechanisms and to determine optimal combination of occlusion pressure and duration of LROT for muscle fitness.

1. Abd Elfattah, A. E. E.,Salem, H. H.(2011).Effect of occlusion swimming training on physiological biomarkers and swimming performance.World Journal of Sport Sciences,4(1),70-75.
2. Abe, T.,Beekley, M. D.,Hinata, S.,Koizumi, K.,Sato, Y.(2005).Day-to-day change in muscle strength and MRI-measured skeletal muscle size during 7 days KAATSU resistance training: A case study.International Journal of KAATSU Training Research,1(2),71-76.
3. Abe, T.,Fujita, S.,Nakajima, T.,Sakamaki, M.,Ozaki, H.,Ogasawara, R.(2010).Effects of low-intensity cycle training with restricted leg blood flow on thigh muscle volume and [難字,請見原文] in young men.Journal of Sports Science and Medicine,9(3),452-458.
4. Abe, T.,Kearns, C. F.,Sato, Y.(2006).Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training.Journal of Applied Physiology,100(5),1460-1466.
5. Abe, T.,Yasuda, T.,Midorikawa, T.,Sato, Y.,Kearns, C. F.,Inoue, K.(2005).Skeletal muscle size and circulating IGF-1 are increased after two weeks of twice daily "KAATSU" resistance training.International Journal of KAATSU Training Research,1(1),6-12.
6. Aoki, M. S.,Soares, A. G.,Miyabara, E. H.,Baptista, I. L.,Moriscot, A. S.(2009).Expression of genes related to myostatin signaling during rat skeletal muscle longitudinal growth.Muscle and Nerve,40(6),992-999.
7. Brodin, G.,Ahgren, A.,Dijke, P. T.,Heldin, C. H.,Heuchel, R.(2000).Efficient TGF-ß induction of the Smad7 gene requires cooperation between AP-1, Sp1, and Smad proteins on the mouse Smad7 promoter.Journal of Biological Chemistry,275(37),29023-29030.
8. Campos, G. E.,Luecke, T. J.,Wendeln, H. K.,Toma, K.,Hagerman, F. C.,Murray, T. F.(2002).Muscular adaptations in response to three different resistance-training regimens: Specificity of repetition maximum training zones.European Journal of Applied Physiology,88(1-2),50-60.
9. Clark, B. C.,Fernhall, B.,Ploutz-Snyder, L. L.(2006).Adaptations in human neuromuscular function following prolonged unweighting: I. Skeletal muscle contractile properties and applied ischemia efficacy.Journal of Applied Physiology,101(1),256-263.
10. Clark, B. C.,Manini, T. M.,Hoffman, R. L.,Williams, P. S.,Guiler, M. K.,Knutson, M. J.(2011).Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults.Scandinavian Journal of Medicine and Science in Sports,21(5),653-662.
11. Clevidence, M. W.,Mowery, R. E.,Kushnick, M. R.(2012).The effects of ischemic preconditioning on aerobic and anaerobic variables associated with submaximal cycling performance.European Journal of Applied Physiology,112(10),3649-3654.
12. Fry, C. S.,Glynn, E. L.,Drummond, M. J.,Timmerman, K. L.,Fujita, S.,Abe, T.(2010).Blood flow restriction exercise stimulates mTORC1 signaling and muscle protein synthesis in older men.Journal of Applied Physiology,108(5),1199-1209.
13. Fujita, S.,Abe, T.,Drummond, M. J.,Cadenas, J. G.,Dreyer, H. C.,Sato, Y.(2007).Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle proteinsynthesis.Journal of Applied Physiology,103(3),903-910.
14. Fujita, T.,Brechue, W. F.,Kurita, K.,Sato, Y.,Abe, T.(2008).Increased muscle volume and strength following six days of low-intensity resistance training with restricted muscle blood flow.International Journal of KAATSU Training Research,4(1),1-8.
15. Hill, J. J.,Qiu, Y.,Hewick, R. M.,Wolfman, N. M.(2003).Regulation of myostatin in vivo by growth and differentiation factor-associated serum protein-1: A novel protein with protease inhibitor and follistatin domains.Molecular Endocrinology,17(6),1144-1154.
16. Holz, M. K.,Ballif, B. A.,Gygi, S. P.,Blenis, J.(2005).mTOR and S6K1 mediate assembly of the translation preinitiation complex through dynamic protein interchange and ordered phosphorylation events.Cell,123(4),569-580.
17. Houtman, C. J.,Heerschap, A.,Zwarts, M. J.,Stegeman, D. F.(2002).An additional phase in PCr use during sustained isometric exercise at 30% MVC in the tibialis anterior muscle.NMR in Biomedicine,15(4),270-277.
18. Houtman, C. J.,Stegeman, D. F.,Van Dijk, J. P.,Zwarts, M. J.(2003).Changes in muscle fiber conduction velocity indicate recruitment of distinct motor unit populations.Journal of Applied Physiology,95(3),1045-1054.
19. Jastrzebski, K.,Hannan, K. M.,Tchoubrieva, E. B.,Hannan, R. D.,Pearson, R. B.(2007).Coordinate regulation of ribosome biogenesis and function by the ribosomal protein S6 kinase, a key mediator of mTOR function.Growth Factors,25(4),209-226.
20. Karabulut, M.,Abe, T.,Sato, Y.,Bemben, M. G.(2010).The effects of low-intensity resistance training with vascular restriction on leg muscle strength in older men.European Journal of Applied Physiology,108(1),147-155.
21. Kawada, S.,Ishii, N.(2005).Skeletal muscle hypertrophy after chronic restriction of venous blood flow in rats.Medicine and Science in Sports and Exercise,37(7),1144-1150.
22. Kim, S. J.,Sherk, V. D.,Bemben, M. G.,Bemben, D. A.(2009).Effects of short-term, low-intensity resistance training with vascular restriction on arterial compliance in untrained young men.International Journal of KAATSU Training Research,5(1),1-8.
23. Kollias, H. D.,Perry, R. L.,Miyake, T.,Aziz, A.,McDermott, J. C.(2006).Smad7 promotes and enhances skeletal muscle differentiation.Molecular and Cellular Biology,26(16),6248-6260.
24. Kosek, D. J.,Bamman, M. M.(2008).Modulation of the dystrophin-associated protein complex in response to resistance training in young and older men.Journal of Applied Physiology,104(5),1476-1484.
25. Kraemer, W. J.,Ratamess, N. A.(2004).Fundamentals of resistance training: Progression and exercise prescription.Medicine and Science in Sports and Exercise,36(4),674-688.
26. Laurentino, G.,Ugrinowitsch, C.,Aihara, A. Y.,Fernandes, A. R.,Parcell, A. C.,Ricard, M.(2008).Effects of strength training and vascular occlusion.International Journal of Sports Medicine,29(8),664-667.
27. Laurentino, G.,Ugrinowitsch, C.,Roschel, H.,Aoki, M. S.,Soares, A. G.,Neves, M., Jr.(2012).Strength training with blood flow restriction diminishes myostatin gene expression.Medicine and Science in Sports and Exercise,44(3),406-412.
28. Le Roith, D.,Bondy, C.,Yakar, S.,Liu, J. L.,Butler, A.(2001).The somatomedin hypothesis: 2001.Endocrine Reviews,22(1),53-74.
29. Lee, S. J.,McPherron, A. C.(2001).Regulation of myostatin activity and muscle growth.Proceedings of the National Academy of Sciences of the United States of America,98(16),9306-9311.
30. Loenneke, J. P.,Thrower, A. D.,Balapur, A.,Barnes, J. T.,Pujol, T. J.(2012).Blood flow-restricted walking does not result in an accumulation of metabolites.Clinical Physiology and Functional Imaging,32(1),80-82.
31. Loenneke, J. P.,Wilson, G. J.,Wilson, J. M.(2010).A mechanistic approach to blood flow occlusion.International Journal of Sports Medicine,31(1),1-4.
32. Louis, E.,Raue, U.,Yang, Y.,Jemiolo, B.,Trappe, S.(2007).Time course of proteolytic, cytokine, and myostatin gene expression after acute exercise in human skeletal muscle.Journal of Applied Physiology,103(5),1744-1751.
33. Madarame, H.,Kurano, M.,Takano, H.,Iida, H.,Sato, Y.,Ohshima, H.(2010).Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects.Clinical Physiology and Functional Imaging,30(3),210-213.
34. Mammucari, C.,Milan, G.,Romanello, V.,Masiero, E.,Rudolf, R.,Del Piccolo, P.(2007).FoxO3 controls autophagy in skeletal muscle in vivo.Cell Metabolism,6(6),458-471.
35. Manini, T. M.,Vincent, K. R.,Leeuwenburgh, C. L.,Lees, H. A.,Kavazis, A. N.,Borst, S. E.(2011).Myogenic and proteolytic mRNA expression following blood flow restricted exercise.Acta Physiologica,201(2),255-263.
36. McDonagh, M. J. N.,Davies, C. T. M.(1984).Adaptive response of mammalian skeletal muscle to exercise with high loads.European Journal of Applied Physiology and Occupational Physiology,52(2),139-155.
37. McFarlane, C.,Plummer, E.,Thomas, M.,Hennebry, A.,Ashby, M.,Ling, N.(2006).Myostatin induces cachexia by activating the ubiquitin proteolytic system through an NF-kappaB-independent, FoxO1-dependent mechanism.Journal of Cellular Physiology,209(2),501-514.
38. Moore, D. R.,Burgomaster, K. A.,Schofield, L. M.,Gibala, M. J.,Sale, D. G.,Phillips, S. M.(2004).Neuromuscular adaptations in human muscle following low intensity resistance training with vascular occlusion.European Journal of Applied Physiology and Occupational Physiology,92(4-5),399-406.
39. Moritani, T.,Sherman, W. M.,Shibata, M.,Matsumoto, T.,Shinohara, M.(1992).Oxygen availability and motor unit activity in humans.European Journal of Applied Physiology and Occupational Physiology,64(6),552-556.
40. Nakajima, T.,Kurano, M.,Sakagami, F.,Iida, H.,Fukumura, K.,Fukuda, T.(2010).Effects of low-intensity KAATSU resistance training on skeletal muscle size/strength and endurance capacity in patients with ischemic heart disease.International Journal of KAATSU Training Research,6(1),1-7.
41. Nielsen, J. L.,Aagaard, P.,Bech, R. D.,Nygaard, T.,Hvid, L. G.,Wernbom, M.(2012).Proliferation of myogenic stem cells in human skeletal muscle in response to low-load resistance training with blood flow restriction.Journal of Physiology,590(17),4351-4361.
42. Patterson, S. D.,Ferguson, R. A.(2010).Increase in calf post-occlusive blood flow and strength following short-term resistance exercise training with blood flow restriction in young women.European Journal of Applied Physiology,108(5),1025-1033.
43. Reeves, G. V.,Kraemer, R.,Hollander, D. B.,Clavier, J.,Thomas, C.,Francois, M.(2006).Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance without occlusion.Journal of Applied Physiology,101(6),1616-1622.
44. Renzi, C. P.,Tanaka, H.,Sugawara, J.(2010).Effects of leg blood flow restriction during walking on cardiovascular function.Medicine and Science in Sports and Exercise,42(4),726-732.
45. Sacheck, J. M.,Ohtsuka, A.,McLary, S. C.,Goldberg, A. L.(2004).IGF-I stimulates muscle growth by suppressing protein breakdown and expression of atrophy-related ubiquitin ligases, atrogin-1 and MuRF1.American Journal of Physiology-Endocrinology and Metabetbolism,287(4),E591- E601.
46. Sambasivan, R.,Yao, R.,Kissenpfennig, A.,Van Wittenberghe, L.,Paldi, A.,Gayraud-Morel, B.(2011).Pax7-expressing satellite cells are indispensable for adult skeletal muscle regeneration.Development,138(17),3647-3656.
47. Sandri, M.,Sandri, C.,Gilbert, A.,Skurk, C.,Calabria, E.,Picard, A.(2004).Foxo transcription factors induce the atrophy-related ubiquitin ligase atrogin-1 and cause skeletal muscle atrophy.Cell,117(3),399-412.
48. Sato, Y.(2005).The history and future of KAATSU Training.International Journal of KAATSU Training Research,1(1),1-5.
49. Suga, T.,Okita, K.,Morita, N.,Yokota, T.,Hirabayashi, K.,Horiuchi, M.(2010).Dose effect on intramuscular metabolic stress during low-intensity resistance exercise with blood flow restriction.Journal of Applied Physiology,108(6),1563-1567.
50. Suga, T.,Okita, K.,Morita, N.,Yokota, T.,Hirabayashi, K.,Horiuchi, M.(2009).Intramuscular metabolism during low-intensity resistance exercise with blood flow restriction.Journal of Applied Physiology,106(4),1119-1124.
51. Suga, T.,Okita, K.,Takada, S.,Omokawa, M.,Kadoguchi, T.,Yokota, T.(2012).Effect of multiple set on intramuscular metabolic stress during low-intensity resistance exercise with blood flow restriction.European Journal of Applied Physiology,112(11),3915-3920.
52. Sugaya, M.,Yasuda, T.,Suga, T.,Okita, K.,Abe, T.(2011).Change in intramuscular inorganic phosphate during multiple sets of blood flow-restricted low-intensity exercise.Clinical Physiology and Functional Imaging,31(5),411-413.
53. Sumide, T.,Sakuraba, K.,Sawaki, K.,Ohmura, H.,Tamura, Y.(2009).Effect of resistance exercise training combined with relatively low vascular occlusion.Journal of Science and Medicine in Sport,12(1),107-112.
54. Sundberg, C. J.(1994).Exercise and training during graded leg ischaemia in healthy man with special reference to effects on skeletal muscle.Acta Physiologica Scandinavica, Supplementum,615,1-50.
55. Takano, H.,Morita, T.,Iida, H.,Asada, K.,Kato, M.,Uno, K.(2005).Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow.European Journal of Applied Physiology and Occupational Physiology,95(1),65-73.
56. Takarada, Y.,Nakamura, Y.,Aruga, S.,Onda, T.,Miyazaki, S.,Ishii, N.(2000).Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion.Journal of Applied Physiology,88(1),61-65.
57. Takarada, Y.,Sato, Y.,Ishii, N.(2002).Effects of resistance exercise combined with vascular occlusion on muscle function in athletes.European Journal of Applied Physiology and Occupational Physiology,86(4),308-314.
58. Takarada, Y.,Takazawa, H.,Ishii, N.(2000).Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles.Medicine and Science in Sports and Exercise,32(12),2035-2039.
59. Takarada, Y.,Takazawa, H.,Sato, Y.,Takebayashi, S.,Tanaka, Y.,Ishii, N.(2000).Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans.Journal of Applied Physiology,88(6),2097-2106.
60. Takarada, Y.,Tsuruta, T.,Ishii, N.(2004).Cooperative effects of exercise and occlusive stimuli on muscular function in low-intensity resistance exercise with moderate vascular occlusion.Japanese Journal of Physiology,54(6),585-592.
61. Wang, X.,Proud, C. G.(2006).The mTOR pathway in the control of protein synthesis.Physiology,21(5),362-369.
62. Wernbom, M.,Augustsson, J.,Raastad, T.(2008).Ischemic strength training: A low-load alternative to heavy resistance exercise?.Scandinavian Journal of Medicine and Science in Sports,18(4),401-416.
63. Yasuda, T.,Abe, T.,Sato, Y.,Midorikawa, T.,Kearns, C. F.,Inoue, K.(2005).Muscle fiber cross-sectional area is increased after two weeks of twice daily KAATSU-resistance training.International Journal of KAATSU Training Research,1(2),65-70.
64. Yasuda, T.,Ogasawara, R.,Sakamaki, M.,Ozaki, H.,Sato, Y.,Abe, T.(2011).Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size.European Journal of Applied Physiology,111(10),2525-2533.
65. Zammit, P.,Relaix, F.,Nagata, Y.,Ruiz, A. P.,Collins, C. A.,Partridge, T. A.(2006).Pax7 and myogenic progression in skeletal muscle satellite cells.Journal of Cell Science,119(9),1824-1832.