FAQ

Blood Flow Restriction Training, commonly referred to as BFR training or BFR (may also be called occlusion training or Kaatsu training), involves the application of a specialized tourniquet cuff to the proximal portion of an exercising arm or leg to reduce arterial inflow and restrict venous outflow from the limb. Exercising in this manner allows the use of low intensity exercise to elicit positive adaptations in muscle size, strength, or endurance typically associated with much heavier loads or higher intensities. The pressure applied with BFR should be personalized to the individual’s Limb Occlusion Pressure or LOP (We often refer to using BFR in this manner as Personalized Blood Flow Restriction or PBFR). A range of pressures can be effective and different pressures may be required for the arm (40-50% of LOP) and for the leg (60-80% of LOP). If you want to dive deeper into BFR, you can find some of the key papers on our Publications Page or a more thorough explanation on our What is Blood Flow Restriction page. You can also see a little more of our personal take on some of the BFR evidence or sub-topics by checking out our Blogs and Podcasts.

Yes, there is a substantial amount of literature that has studied the effects of BFR. In fact, a recent meta-analysis found a total of more than 1400 unique articles pertaining to BFR. BFR consistently demonstrates greater results compared to work matched controls exercising without PBFR. The positive results have been seen in patients after injury, in the elderly, and in athletes. It has also been applied extensively in a military rehabilitation setting on severely compromised patients.

Find some publications on our Research page.

Yes, the available literature indicates that BFR is as safe an exercise intervention as any other form of exercise. Like any other exercise intervention, it can be graded or modified in a number of ways to individualize it to the user. The application of BFR in an individualized manner has consistently demonstrated safety and effectiveness. Presently, it has been performed on thousands of subjects in the peer-reviewed literature with few and infrequent side effects.

The review papers on our Publications Page provide a good summary of the safety profile seen with BFR in the literature.

Additional topics and resources that relate to the safety discussion:

• VTE/DVT
  • Podcast with the folks that wrote the Clinical Practice Guidelines
  • Blog on BFR and VTE
• Hemodynamics
  • Podcast with Jamie Burr, PhD
  • Blog on hemodynamics

BFR can be used as a strategy to make available exercises stressful enough to induce an adaptive response. Almost any patient that is cleared to participate in exercise but can’t perform exercise at a high enough intensity to cause adaptation could benefit from Blood Flow Restriction Training.

If you want to dive a little deeper or see some examples of how BFR has been used, here are some blogs and podcasts where you can find more information.

• Blogs
  • BFR After Anterior Cruciate Ligament Reconstruction
    • Managing ACLs with PBFR
    • More than Just Muscle
  • Managing Muscle Strains
  • BFR for the Older Individual
  • BFR and Pain
• Podcasts
  • Heart Failure and BFR?
  • The Chanda Plan Podcast
  • BFR in Persons with Multiple Sclerosis with Mark Mañago, PT, DPT, PhD, NCS
  • BFR in Neuro Rehab with Nicole Walter, PT

Physical therapists have an existing firm foundation in anatomy, physiology, therapeutic exercise, and the cardiorespiratory system, as well as clinical reasoning, which are the components of the safe application of blood flow restriction training.

Physical therapist education provides PTs with the requisite knowledge (muscular and vascular anatomy, and physiology and exercise physiology), as well as skills (therapeutic exercise prescription, monitoring of physiological vital signs and blood flow) to perform and monitor this type of therapeutic exercise. BFRT is part of the professional scope of practice for physical therapists.

Link to APTA: What to Know About Blood Flow Restriction Training

Similarly, the Board of Certification put out some information through an Approved Provider update on whether Athletic Trainers are appropriate to perform BFR. “ATs are healthcare professionals and fall under the scope of clinicians qualified to learn and perform BFR.” They also went on to say “Advanced continuing education through the Board of Certification is currently utilized to ensure ATs are taught the efficacy and safety of BFR and proper medical tourniquet applications.”

Technically, anyone can register and take the BFR Certification course. However, the course is geared towards medical professionals involved in rehabilitation after injury and the only CEU approvals we have in place are for Physical Therapists, Physical Therapy Assistants, and Athletic Trainers. We have applied for and received credit for Occupational Therapists and Chiropractors upon request.

Find our available courses on the Courses page.

At this time, only licensed medical healthcare providers that have completed an Owens Recovery Science, INC PBFR certification training may purchase a Delfi PTS for PBFR system. This includes the following providers: Medical Doctors, Physical Therapists, Athletic Trainers, Chiropractors and Occupational Therapists.

If you’re interested in purchasing or need a formal quote, submit your request on our Purchase page.

There is no requirement to purchase a device associated with the course. We pride ourselves on providing the best educational product on the science behind BFR and the variables involved in its application. You can take the information provided in the course and apply it as you see fit.

We commonly get asked about how the Delfi device compares to others in the market. For starters, Delfi has been making devices that restrict the flow of blood into limbs for forty years. Partnering with a company that has a history of doing good work, having a means to continue to innovate and improve their product, and the ability to provide the level of service our customers expect from us was imperative. Additionally, Delfi’s technology is chiefly responsible for modernizing surgical suite tourniquet systems that we know today with the invention of the microprocessor, changing tourniquet systems to computerized control of pressure and thus improving accuracy and decreasing risk (1980). Prior to that, tourniquet systems had a higher likelihood for causing nerve injuries from excessive pressure. All tourniquet systems that are used in surgical suites today are based on the Delfi microprocessor design. Delfi more recently patented the technology that measures limb occlusion pressure (LOP) and despite the BFR industry being nearly a decade old, it remains the only patent on LOP.

Additionally, the Delfi BFR system has independent research validation showing that it does what it claims to do, both in the assessment of limb occlusion pressure (Link) and in the application of consistent pressure throughout exercise (Link). There are currently 90 or so publications on the application of BFR with the Delfi system. If you have trouble finding papers, submit a contact submission or send us an email and we’re happy to share.

It's really up to you as the clinician to decide what you feel is necessary to apply BFR clinically and how objective that application needs to be. We typically recommend that whatever device you choose to use, be able to defend why you chose it.

Yes! In fact we love for students to take our course and we offer a nice discount on course cost to those enrolled in a healthcare program such as physical therapy school or an athletic training program. Taking the certification course as a student can potentially make you more marketable to employers as you enter the job market. 

Send inquiries to http://www.owensrecoveryscience.com/contact/

There are no billing codes specific to BFR. Most clinicians are billing for BFR under the codes for Therapeutic Exercise, Neuromuscular Re-education, or Therapeutic Activity.

Yes. We are able to process your order at any time. The unit will be shipped to your physical address after your course completion.

The unit is very light and portable. The exact dimensions of the tourniquet are:

Height: 180 mm (7.0 inches)

Width: 120 mm (4.7 inches)

Depth: 110 mm (4.3 inches)

Weight: 1.08 kg (38.0 oz)

In the clinical setting using a rolling stand makes it very easy to move the system and protects it from getting knocked off a treatment table.

See our purchase page for examples.

Any device service or calibration will go directly through the manufacturer, Delfi Medical. You can email their service department directly at service@delfimedical.com. Please include the device serial number and a description of any issues you’re experiencing when you reach out.

If you just need to order a replacement part, that can be done through us and you can submit a purchase request form or email our purchasing department directly at purchasing@ors.io.