Occlude, Dalgas Avenue 4, Aarhus (2026)

31/10/2025

𝐒𝐡𝐨𝐮𝐥𝐝 𝐁𝐅𝐑 𝐛𝐞 𝐭𝐡𝐞 𝐟𝐢𝐫𝐬𝐭-𝐥𝐢𝐧𝐞 𝐭𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐟𝐨𝐫 𝐩𝐚𝐭𝐢𝐞𝐧𝐭𝐬 𝐰𝐢𝐭𝐡 𝐤𝐧𝐞𝐞 𝐨𝐬𝐭𝐞𝐨𝐚𝐫𝐭𝐡𝐫𝐢𝐭𝐢𝐬?

Osteoarthritis (OA) is among the leading causes of pain and disability worldwide, with the knee being the most commonly affected joint. Current clinical guidelines recommend patient education and neuromuscular exercise, as in the GLA:D Concept (Good Life with osteoArthritis in Denmark), now implemented internationally.

In recent years, blood flow restriction ( ) exercise has been proposed as an alternative to traditional high-load strength training for patients with knee OA – particularly for those who cannot tolerate heavy resistance due to pain, which often reduces adherence (Wang, 2022). These reports align with our practical experience and the feedback we receive from health care professionals during our courses and workshops, highlighting a clear need for additional tools in the OA exercise toolbox – especially for patients who are pain-compromised.

Two recently published studies by a Danish research group (Sørensen et al., 2025 A+B, see refs in comments) compared blood flow restriction resistance exercise (BFR-RE) to a standard neuromuscular exercise (NEMEX) program, both including two hours of patient education.

96 patients with unilateral knee OA completed 12 weeks of training where allocated to either:
1️⃣ BFR-RE (n = 47): 2 sessions/week of unilateral knee extension and leg press (30-15-15-failure) with, 60–80% AOP, ~40 min/session, cuff: Occlude BFR.
2️⃣ NEMEX (n = 49): 2 sessions/week of circuit-based strength training (pelvic lifts, lunges, hip/knee exercises, sit-to-stand, stair climbing), 2–3 sets of 10–15 reps, ~60 min/session.

𝗦𝘁𝘂𝗱𝘆 𝗔 – 𝗣𝗮𝘁𝗶𝗲𝗻𝘁-𝗿𝗲𝗽𝗼𝗿𝘁𝗲𝗱 𝗼𝘂𝘁𝗰𝗼𝗺𝗲𝘀 𝗮𝗻𝗱 𝗳𝘂𝗻𝗰𝘁𝗶𝗼𝗻:
Both groups improved KOOS and Oxford Knee Scores (OKS), but BFR-RE showed a tendency toward greater pain reduction and clinically relevant change. At 12 weeks, BFR-RE produced superior gains in gait speed, stair climbing, sit-to-stand performance, and reduced pain sensitization.

Continued in comments:

06/01/2025

New blog post about the design and progression of blood flow restriction training protocols now available on www.occludebfr.com
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Find the link in bio
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05/11/2024

📸 A few impressions from our latest BFR course this saturday in collaboration with
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All smiles, hard work and interesting discussions for 7 hours 🤓😃💪
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If you are interested in learning more about our workshops and courses leave us a DM 📥 or send an e-mail to ac@occlude.dk

29/10/2024

Passive blood flow restriction - To contract or not?
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The recovery from illness or injury can require otherwise healthy individuals to undergo a period of muscle disuse (e.g. bed rest or limb immobilization). A major consequence of disuse is skeletal muscle atrophy with evidence showing a substantial decline in muscle mass and strength after only 5 days of limb immobilization (Wall, 2014). The rapid loss in muscle mass with immobilization is particular for anti-gravity muscles such as the quadriceps, and also occurs with a faster rate after surgery compared to “controlled immobilization” of healthy individuals.
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Passive application of blood flow restriction is a proposed method to minimize loss in muscle mass and function (Patterson, 2019 & Scott, 2023). Early papers of Takarada (2000) and Kubota (2008 & 2011) support the use of passive BFR to minimize loss in muscle mass and/or function with a [5 x 5 min, 3 min rest, 2 x d for 2 wk, pressure; 50-260 mmHg], however later research from Iversen (2016), who also used post-op patients after ACL reconstruction as Takarada, failed to find improvements with the same BFR protocol added to a standard-care treatment.
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Indirect evidence from Nyakayiru 2019, found that only BFR with exercise increased myofibrillar protein synthesis rates at 5-h post stimuli compared to a passive BFR application in resting conditions, indicating a need to add muscle contraction to utilize the effect of BFR.
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In a recently published study (Fuchs 2024) a group of researchers measured the impact of BFR on muscle protein synthesis rates, muscle mass and strength during 2 weeks of strict bed rest in 12 healthy male adults. One leg received passive BFR (3 x 5 min inflation w. 1.5 min rest, 3 times/day, pressure: 200 mmHg, 45 min total BFR/day for 14 days) while the other leg served as control. The results showed that both legs had significant loss in muscle mass and strength and there was no difference between conditions.

In contrast, the use of passive BFR has been found to reduce muscle atrophy in elderly coma patient in the intensive care unit (ICU). Like Fuchs, Barbalho 2018 also used a with-in patient design, where one leg received passive mobilization + BFR (intervention) and the other leg only received passive mobilization (control). The authors found that both legs atrophied during ICU but the loss in muscle mass was lower after BFR + passive mobilization.

With conflicting results in the litterature it remains unknown if passive BFR alone can protect against muscle atrophy. We tend to support that some sort of muscle contraction leading to single fiber mechanical tension is needed with BFR, as it is proposed to be the primary mechanism driving muscle hypertrophy (Wackerhage 2019).

One way of adding involuntary muscle contraction is with Neuromuscular Electrical Stimulation (NMES). NMES is commonly used as a rehabilitative technique for preventing muscle atrophy during immobilization periods. It is proposed that the combination of BFR and NMES provides a synergistic effect in which hypertrophy may be possible as a passive intervention. In a with-in patient design, a high frequenzy training protocol; twice daily, 5d/week for 2 wk consisting of involuntary NMES combined with BFR (NMES-BFR leg) improved isometric and isokinetic quadriceps strength and muscle mass. The control leg (NMES-only leg), only had a negligible effect on isometric strength (Natsume 2015).

Likewise, the use of synergist exercises (hip abduction, adduction or flexion) or early very-low load exercises with limited range of motion (seated quadriceps contractions and closed chain knee extensions) can be effective strategies to add muscle contraction within the limitations of an injury or post-surgery. 12 (Jack 2023) and 16 week (Ohta 2003) training including these modalities with BFR following ACL reconstruction improved outcome parameters like strength, muscle mass and time for return-to-activity.

13/09/2024

[DA] I samarbejde med Ikast Fysioterapi & Træning inviterer vi til basiskursus i okklusionstræning, lørdag d. 2. november kl. 10.00-17.00 ⠀⠀⠀⠀⠀⠀⠀⠀⠀
Mere information og link til tilmelding i bio

09/08/2024

Designing blood flow restriction training protocols - Part 3.1: Modalities combined with BFR training

In Part 1 and Part 2 we presented the load-pressure continuum and the BFR Exercise Intensity Ladder. In this third post about the design of BFR training protocols we will take a look at the most commonly used modality in combination with BFR: Low-load (LL) resistance training.

LL BFR resistance training is typically performed at intensities from 20-40 % of 1RM with pressures ranging from 40-80 % of AOP and it is the most frequently used type of BFR training protocol.

Traditionally, this type of BFR protocol either uses a fixed rep-scheme (30-15-15-15 reps) or 3-4 sets to voluntary concentric failure seperated by 30-60 seconds between sets with a weekly frequency of 2-3 times when performed for more than 3 weeks (Patterson et al., 2019).

However, data from a recently published meta-analysis adds a third type of low-load BFR protocol; multiple sets of 15 repetitions that despite the smaller repetition volume seems to be just as effective in increasing muscle mass as the latter two aswell as heavy load resistance training (de Queiros & Rolnick et al., 2024).

LL BFR training performed in proximity to muscle failure is associated with an increase in pain and discomfort why these recent findings are of important notice, especially for pain sensitive patients and non-athlete populations. If we can minimize the discomfort and pain with BFR training using the “multiple 15 rep protocol” while maintaining a robust training response, this could potentially remove one of the proposed barriers to BFR training (Rolnick 2021) and improve long-term adherence to LL-BFR training.

LL exercises using both single and multi-joint movements can be effective with BFR. We recommend the use of exercises with a low level of complexity (minimize balance and the need to control the path of the weight) that allow us to focus on muscle fatigue, why machines with a fixed range of motion often is a great go-to. For the highly trained individual used to BFR training supersets like "antagonist-supersets" can also be a time-efficient approach.

⬅️ Swipe to see a couple of our most used LL-BFR exercises

And stay tuned for part 3.2 where we will look into BFR aerobic exercise

27/06/2024

Designing blood flow restriction training protocols - Part 2: The BFR Exercise Intensity Ladder
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Understanding the different levels of exercise intensities used in BFR training (the mechanical loads imposed in training) helps practitioners to better design and progress effective training protocols.
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⬆️ At the top of ”The BFR Exercise Intensity Ladder” is low-load BFR resistance training with intensities ~ 20-40 % of 1RM. Protocols are rep-based.
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➡️ Aerobic ergometer training represent the middle step of the ladder with an intensity prescription < 50 % of VO2 max. Protocols are timed-based.
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⬇️ The entry level of the ladder uses passive or very-low loads (up to 15 % of 1RM) with a wide varity of application or form of exercise. Protocols are both time and rep-based.
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In Part 3 we will do an in-depth presentation of the specific modalities of BFR training and how they can be applied - Stay tuned!

13/06/2024

Designing blood flow restriction training protocols - Part 1: The load-pressure continuum
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The load-pressure continuum describes the inverse relationship between the load (% of 1RM) and pressure (% of AOP) used in Blood Flow Restriction (BFR) training.
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When the loads are very low (approaching zero 0 % of 1RM / passive application), higher cuff pressures are needed to accelerate muscle fatigue and promote training adaptations.
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Conversely, when the loads are high (up to 50 % of 1RM), lower cuff pressures are sufficient to achieve the same effects but with less discomfort.
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➡️ In Part 2 we will present the different modalities commonly used in combination with BFR and their relation to the load-pressure continuum - Stay tuned!

23/03/2024

A fantastic day in Oslo: 21 Norwegian Physical Therapists now educated in BFR training
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A few impressions 📸 from our latest course in BFR training. Our next international course is in May, where we will be visiting Gothenburg.
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If you want to learn more about our courses and workshops, feel free to leave a DM or send an e-mail to ac@occlude.dk

01/03/2024

How does BFR training work?
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Visit www.occludebfr.com [int] or www.occlude.dk [da] for more info about BFR training, our professional equipment and the courses & workshops we provide, or leave us a DM 📥
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12/01/2024

Low-intensity sprint and acceleration drills with BFR: A useful tool in “return-to-sport” or useless Instagram exercises?

Background: Short sprint performance can be divided in two main phases:
1️⃣ Acceleration: Accelerating the body in a forward motion (think of a 100 m sprinter out of the blocks) requires large propulsive forces. As running speed increases, net anterior-posterior forces approach zero, as the propulsive force in each step (the “push-off”) and breaking force (initial foot touch down) + wind resistance in flight-phase equals each other.

2️⃣Maximal sprinting: As running speed increases, so does the requirement to produce larger vertical forces to support COM against gravity and the natural (and needed!) vertical oscillation in running (Nagahara et al., 2018)

Return-to-running or sprinting with blood flow restriction training: When track athletes, field-sport athletes or even recreational runners suffer from lower extremity injuries, running and acceleration, especially at higher intensities, are often impossible until late stages of rehab, due to the large horizontal and vertical forces involved. Instead, non-, or low-impact ergometers (bikes, rowing, crosstrainer, etc.) are often used to maintain basic fitness levels.

However, to protect against any loss of technical or physical ability in a sport or activity (especially important if you are an athlete returning to competition), one should consider integrating an appropriate and tolerable amount (injury-dependent) of sports-specific training to maintain optimal mechanics and tissue-specific loading, to accelerate long-term return-to-play.

One way of doing so is with low-intensity coordination drills; in the video, specific to running and acceleration mechanics, in combination with blood flow restriction. By applying BFR we accelerate muscle fatigue and build tissue capacity and strength, possibly on a multifactorial level; muscles (Abe et al., 2015), tendons (Centner et al., 2019 + 2021) and bones (Wang et al., 2023) all important in rehab, while maintaining specific movement patterns.

A concern is that applying BFR to sports-specific exercises can create unnatural movements and negatively impact locomotion and technique (Scott et al., 2023) which we completely agree with.

We believe that BFR has its potential to improve the outcome of low-intensity return-to-running/sprinting and acceleration drills but one should pay attention to the fine line between using BFR in the early stages with enhanced effect, and avoid a possible counter-effect if combined with higher intensity exercises that require optimal technical ex*****on.

What are your thoughts on this and the exercises we have chosen? Leave a comment below ⬇️

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