Revisión de los procesos de hipertrofia muscular inducida por el entrenamiento de fuerza oclusivo
Publicado en Rev Andal Med Deporte.2011; 04 :152-7 - vol.04 núm 04
Resumen
El American College of Sports Medicine recomienda el uso de intensidades superiores al 70% con 1 repetición máxima (RM) para inducir hipertrofia a través del entrenamiento con resistencias. El entrenamiento de alta intensidad produce una activación máxima de la musculatura, tanto a nivel neurológico como mecánico. En cambio, el ejercicio con resistencias de intensidad baja (20-50% con 1 RM), en combinación con la restricción del flujo sanguíneo en la parte proximal de la articulación que se quiere entrenar, ha demostrado ser capaz de inducir también hipertrofia muscular. Este hecho se ha demostrado en poblaciones de individuos sanos sedentarios, físicamente activos y deportistas, así como en ancianos y pacientes en período de rehabilitación. El entrenamiento en isquemia es un método novedoso y alternativo para poblaciones que no sean capaces de movilizar cargas de alta intensidad. Aún no se han esclarecido los mecanismos a través de los cuales este tipo de entrenamiento es capaz de inducir hipertrofia muscular, aunque la acumulación metabólica inducida por la restricción del aclarado venoso y el incremento de la tasa de síntesis proteica parecen ser los mecanismos más probables. En esta revisión se quiere ofrecer una descripción de la aplicación práctica y las adaptaciones musculares estructurales inducidas por este tipo de entrenamiento, así como una discusión sobre sus posibles mecanismos de acción.
Palabras clave Hipoxia. Entrenamiento de fuerza. Sarcopenia. Oclusión vascular. Acumulación metabólica.
Introducción
Introducción
A pesar de que actualmente hay cierta controversia1, las recomendaciones tradicionales, respaldadas por el posicionamiento del American College of Sports Medicine, establecen que la intensidad adecuada de entrenamiento para incrementar la fuerza máxima o el tamaño muscular debe superar el 70% con 1 repetición máxima (RM)2,3. Con el entrenamiento con resistencias de alta intensidad se quiere conseguir una gran solicitación neurológica y mecánica de la musculatura, que estimule los procesos de activación y coordinación muscular y, posteriormente, de síntesis proteica y anabolismo, que tendrán como consecuencia el incremento de la fuerza y la hipertrofia muscular. Los estímulos en este umbral de intensidad son capaces de producir adaptaciones metabólicas o cardiovasculares, pero no de producir un crecimiento muscular sustancial4.
En cambio, hay una nueva concepción de entrenamiento, surgida en Japón aproximadamente hace una década, que combina el ejercicio de baja intensidad con la hipoxia tisular para el incremento de la fuerza y el tamaño muscular. Este tipo de entrenamiento se conoce como Kaatsu en Japón, aunque los autores occidentales se refieren a él como entrenamiento oclusivo (occlusive training) o entrenamiento con restricción del flujo sanguíneo (blood flow restricted training). Para generar la oclusión, se comprime la zona proximal de la extremidad que se quiere entrenar, lo cual induce una situación de hipoxia local que, unida a la supresión del aclarado metabólico, resulta un estímulo adicional al entrenamiento con resistencias de baja intensidad (20-50% con 1 RM)5.
A pesar de que aún no...
Bibliografía
1. Burd NA, West DW, Staples AW, Atherton PJ, Baker JM, Moore DR, et al. Low-load high volume resistance exercise stimulates muscle protein synthesis more than high-load low volume resistance exercise in young men. PLoS ONE. 2010;5:e12033.
Pubmed
2. Kraemer WJ, Adams K, Cafarelli E, Dudley GA, Dooly C, Feigenbaum MS, et al. American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc. 2002;34:364-80.
Pubmed
3. Rhea MR, Alvar BA, Burkett LN, Ball SD. A meta-analysis to determine the dose response for strength development. Med Sci Sports Exerc. 2003;35: 456-64.
Pubmed
4. Campos GE, Luecke TJ, Wendeln HK, Toma K, Hagerman FC, Murray TF, et al. Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones. Eur J Appl Physiol. 2002;88:50-60.
Pubmed
5. Manini TM, Clark BC. Blood flow restricted exercise and skeletal muscle health. Exerc Sport Sci Rev. 2009;37:78-85.
Pubmed
6. Moritani T, Sherman WM, Shibata M, Matsumoto T, Shinohara M. Oxygen availability and motor unit activity in humans. Eur J Appl Physiol Occup Physiol. 1992;64:552-6.
Pubmed
7. Takarada Y, Nakamura Y, Aruga S, Onda T, Miyazaki S, Ishii N. Rapid increase in plasma growth hormone after low-intensity resistance exercise with vascular occlusion. J Appl Physiol. 2000;88:61-5.
Pubmed
8. Drummond MJ, Fujita S, Abe T, Dreyer HC, Volpi E, Rasmussen BB. Human muscle gene expression following resistance exercise and blood flow restriction. Med Sci Sports Exerc. 2008;40:691-8.
Pubmed
9. Fry CS, Glynn EL, Drummond MJ, Timmerman KL, Fujita S, Abe T, et al. Blood flow restriction exercise stimulates mTORC1 signaling and muscle protein synthesis in older men. J Appl Physiol. 2010;108:1199-209.
Pubmed
10. Loenneke JP, Wilson GJ, Wilson JM. A mechanistic approach to blood flow occlusion. Int J Sports Med. 2010;31:1-4.
Pubmed
11. Laurentino G, Ugrinowitsch C, Aihara AY, Fernandes AR, Parcell AC, Ricard M, et al. Effects of strength training and vascular occlusion. Int J Sports Med. 2008;29:664-7.
Pubmed
12. Patterson SD, Ferguson RA. Increase in calf post-occlusive blood flow and strength following short-term resistance exercise training with blood flow restriction in young women. Eur J Appl Physiol. 2010;108:1025-33.
Pubmed
13. Kubo K, Komuro T, Ishiguro N, Tsunoda N, Sato Y, Ishii N, et al. Effects of low-load resistance training with vascular occlusion on the mechanical properties of muscle and tendon. J Appl Biomech. 2006;22:112-9.
Pubmed
14. Shinohara M, Kouzaki M, Yoshihisa T, Fukunaga T. Efficacy of tourniquet ischemia for strength training with low resistance. European J Appl Physiol Occup Physiol. 1998;77:189-91.
15. Sakuraba K, Ishikawa T. Effect of isokinetic resistance training under a condition of restricted blood flow with pressure. J Orthop Sci. 2009;14:631-9.
Pubmed
16. Takarada Y, Tsuruta T, Ishii N. Cooperative effects of exercise and occlusive stimuli on muscular function in low-intensity resistance exercise with moderate vascular occlusion. Jpn J Physiol. 2004;54:585-92.
Pubmed
17. Loenneke JP, Pujol TJ. The use of occlusion training to produce muscle hypertrophy. Strength Cond J. 2009;31:77-84.
18. Ohta H, Kurosawa H, Ikeda H, Iwase Y, Satou N, Nakamura S. Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction. Acta Orthop Scand. 2003;74:62-8.
Pubmed
19. Clark BC, Manini TM, Hoffman RL, Williams PS, Guiler MK, Knutson MJ, et al. Relative safety of 4 weeks of blood flow-restricted resistance exercise in young, healthy adults. Scand J Med Sci Sports. 2011;21:653-62.
Pubmed
20. Wernbom M, Augustsson J, Raastad T. Ischemic strength training: a low-load alternative to heavy resistance exercise? Scand J Med Sci Sports. 2008;18:401-16.
21. Shaw JA, Murray DG. The relationship between tourniquet pressure and underlying soft tissue pressure in the thigh. J Bone Joint Surg (Am). 1982; 64:1148-52.
22. Sumide T, Sakuraba K, Sawaki K, Ohmura H, Tamura Y. Effect of resistance exercise training combined with relatively low vascular occlusion. J Sci Med Sport. 2009;12:107-12.
Pubmed
23. Abe T, Kearns CF, Sato Y. Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. J Appl Physiol. 2006;100:1460-6.
Pubmed
24. Abe T, Yasuda T, Midorikawa T, Sato Y, Kearns CF, Inoue K, et al. Skeletal muscle size and circulating IGF-1 are increased after two weeks of daily "KAATSU" resistance training. Int J Kaatsu Training Res. 2005;1:6-12.
25. Takarada Y, Sato Y, Ishii N. Effects of resistance exercise combined with vascular occlusion on muscle function in athletes. Eur J Appl Physiol. 2002;86:308-14.
Pubmed
26. Takarada Y, Takazawa H, Sato Y, Takebayashi S, Tanaka Y, Ishii N. Effects of resistance exercise combined with moderate vascular occlusion on muscular function in humans. J Appl Physiol. 2000;88:2097-106.
Pubmed
27. Burgomaster KA, Moore DR, Schofield LM, Phillips SM, Sale DG, Gibala MJ. Resistance training with vascular occlusion: Metabolic adaptations in human muscle. Med Sci Sports Exerc. 2003;35:1203-8.
Pubmed
28. Loenneke JP, Wilson JM, Wilson GJ, Pujol TJ, Bemben MG. Potential safety issues with blood flow restriction training. Scand J Med Sci Sports. 2011; 21:510-8.
Pubmed
29. Madarame H, Kurano M, Takano H, Iida H, Sato Y, Ohshima H, et al. Effects of low-intensity resistance exercise with blood flow restriction on coagulation system in healthy subjects. Clin Physiol Funct Imaging. 2010;30: 210-3.
Pubmed
30. Nakajima T, Kurano M, Iida H, Takano H, Oonuma H, Morita T, et al. Use and safety of KAATSU training: Results of a national survey. Int J Kaatsu Training Res. 2006;2:5-13.
31. Renzi CP, Tanaka H, Sugawara J. Effects of leg blood flow restriction during walking on cardiovascular function. Med Sci Sports Exerc. 2010;42:726-32.
Pubmed
32. Takano H, Morita T, Iida H, Asada K, Kato M, Uno K, et al. Hemodynamic and hormonal responses to a short-term low-intensity resistance exercise with the reduction of muscle blood flow. Eur J Appl Physiol. 2005;95:65-73.
Pubmed
33. Nakajima T, Takano H, Kurano M, Iida H, Kubota N, Yasuda T, et al. Efects of KAATSU training on haemostasis in healthy subjects. Int J Kaatsu Training Res. 2007;3:11-20.
34. Sale DG. Neural adaptation to resistance training. Med Sci Sports Exerc. 1988;20(5 Suppl):S135-45.
Pubmed
35. Yasuda T, Fujita S, Ogasawara R, Sato Y, Abe T. Effects of low-intensity bench press training with restricted arm muscle blood flow on chest muscle hypertrophy: a pilot study. Clin Physiol Funct Imaging. 2010;30:338-43.
Pubmed
36. Madarame H, Neya M, Ochi E, Nakazato K, Sato Y, Ishii N. Cross-transfer effects of resistance training with blood flow restriction. Med Sci Sports Exerc. 2008;40:258-63.
Pubmed
37. Wernbom M, Augustsson J, Thomee R. Effects of vascular occlusion on muscular endurance in dynamic knee extension exercise at different sub-maximal loads. J Strength Cond Res. 2006;20:372-7.
Pubmed
38. Wernbom M, Jarrebring R, Andreasson MA, Augustsson J. Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load. J Strength Cond Res. 2009;23: 2389-95.
Pubmed
39. Abe T, Sakamaki M, Fujita S, Ozaki H, Sugaya M, Sato Y, et al. Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in older adults. J Geriatr Phys Ther. 2010;33:34-40.
Pubmed
40. Abe T, Fujita S, Nakajima T, Skamaki M, Ozaki H, Ogasawara R, et al. Effects of low intensity cycle training with restricted blood flow on thigh muscle volume and VO2max in young men. J Sports Sci Med. 2010;9:452-8.
41. Yokokawa Y, Hongo M, Urayama H, Nishimura T, Kai I. Effects of low-intensity resistance exercise with vascular occlusion on physical function in healthy elderly people. Biosci Trends. 2008;2:117-23.
Pubmed
42. Loenneke JP, Fahs CA, Wilson JM, Bemben MG. Blood flow restriction: The metabolite/volume threshold theory. Med Hypotheses. 2011;77:748-52.
Pubmed
43. Meyer RA. Does blood flow restriction enhance hypertrophic signaling in skeletal muscle? J Appl Physiol. 2006;100:1443-4.
44. Greenhaff PL, Soderlund K, Ren JM, Hultman E. Energy metabolism in single human muscle fibres during intermittent contraction with occluded circulation. J Physiol. 1993;460:443-53.
Pubmed
45. Goldfarb AH, Garten RS, Chee PD, Cho C, Reeves GV, Hollander DB, et al. Resistance exercise effects on blood glutathione status and plasma protein carbon-yls: influence of partial vascular occlusion. Eur J Appl Physiol. 2008;104:813-9.
Pubmed
46. Hoffman JR, Im J, Rundell KW, Kang J, Nioka S, Speiring BA, et al. Effect of muscle oxygenation during resistance exercise on anabolic hormone response. Med Sci Sports Exerc. 2003;35:1929-34.
Pubmed
47. Kon M, Ikeda T, Homma T, Akimoto T, Suzuki Y, Kawahara T. Effects of acute hypoxia on metabolic and hormonal responses to resistance exercise. Med Sci Sports Exerc. 2010;42:1279-85.
Pubmed
48. Madarame H, Sasaki K, Ishii N. Endocrine responses to upper- and lower-limb resistance exercises with blood flow restriction. Acta Physiol Hung. 2010;97:192-200.
Pubmed
49. Pierce JR, Clark BC, Ploutz-Snyder LL, Kanaley JA. Growth hormone and muscle function responses to skeletal muscle ischemia. J Appl Physiol. 2006;101:1588-95.
Pubmed
50. Reeves GV, Kraemer RR, Hollander DB, Clavier J, Thomas C, Francois M, et al. Comparison of hormone responses following light resistance exercise with partial vascular occlusion and moderately difficult resistance exercise without occlusion. J Appl Physiol. 2006;101:1616-22.
Pubmed
51. Viru M, Jansson E, Viru A, Sundberg CJ. Effect of restricted blood flow on exercise-induced hormone changes in healthy men. Eur J Appl Physiol Occup Physiol. 1998;77:517-22.
Pubmed
52. Kawada S. What phenomena do occur in blood flow-restricted muscle? Int J Kaatsu Training Res. 2005;1:37-44.
53. Kawada S, Ishii N. Skeletal muscle hypertrophy after chronic restriction of venous blood flow in rats. Med Sci Sports Exerc. 2005;37:1144-50.
Pubmed
54. Fujita S, Abe T, Drummond MJ, Cadenas JG, Dreyer HC, Sato Y, et al. Blood flow restriction during low-intensity resistance exercise increases S6K1 phosphorylation and muscle protein synthesis. J Appl Physiol. 2007;103: 903-10.
Pubmed
55. Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 2005;35:339-61.
Pubmed
56. Rennie MJ. Claims for the anabolic effects of growth hormone: a case of the emperor''s new clothes? Br J Sports Med. 2003;37:100-5.
Martín-Hernández, J.a; Marín, P.J.a; Herrero, A.J.a
aCentro de Investigación en Discapacidad Física. Asociación ASPAYM Castilla y León. Simancas. Valladolid. España.