Fundamentals of Blood Flow Restriction Training

This live, 8-hour certification program covers the skills necessary to safely and effectively implement Blood Flow Restriction (BFR) Training. The course is set up in a “learn by doing” format in which participants will receive hands-on instruction in the proper use of BFR Equipment and Training. After understanding the history, research, physiology, and implications for use, attendees will put this into practice in supervised lab sessions. They will be exposed to exercise protocols and provided with resources to ensure safe training.

In order to be certified, attendees will be required to pass a 20-question certification exam at the conclusion of the course, with a passing score of 70%.

Course Objectives:

At the completion of this program the participant will be able to:

  • Describe how the design of B Strong BFR bands doesn’t cause arterial occlusion.
  • Explain the benefits of Blood Flow Restriction Training.
  • Explain the mechanisms of Blood Flow Restriction Training.
  • Correctly list at least 4 of the precautions and contraindications to B Strong BFR as presented in the course.
  • Compare the 5 differences between utilizing a wide rigid cuff versus a narrow elastic cuff as presented in the course.
  • Plan an upper extremity, lower extremity, and total body exercise program for a client using BFR training.

CE Credits

8 contact hours

BOC Skill Level: Essential

This course is accepted by many professional credentialing organizations and state professional regulatory boards. Rules and regulations change frequently without notification, and apply differently to live and online courses. Please check with your state board to confirm accuracy of this list and acceptance of contact hours. Certificate of Attendance will be issued to all participants upon completion of the course and may be used for CEU verification of credits. CE credits vary by state. Please check with your state board/certifying agency to confirm conversion of contact hours to CE. See links below.


Physical Therapy Board of California: The Physical Therapy Board of California recognizes Rehab Education, LLC as an approval agency to approve providers offering continuing competency courses for CA licensed PTs and PTAs. This course is approved for 8 contact hours.

New Jersey State Board of Physical Therapy Examiners: This course has been approved by the New Jersey State Board of Physical Therapy Examiners for 8 continuing education credits, Approval #2001-74. (Course must be taken between 03-24-2020 and 01-31-2022).

NY State Physical Therapy Board: Rehab Education, LLC is recognized as an approved provider of PT and PTA continuing education by the NY State Education Department Board of Physical Therapy. (Course must be taken between 07-18-2014 and 05-10-2022)

Board of Certification, Inc (BOC) Approved Provider #P8271: Rehab Education, LLC is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. This program is eligible for a maximum of 7 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

American Occupational Therapy Association (AOTA) Approved Provider #6177: See states that currently recognize AOTA Approved Providers for OT

  • AOTA Approval States

    These states currently recognize AOTA Approved Providers for OT continuing education either in regulatory language or by formal written communication to AOTA:

    District of Columbia
    New Hampshire
    New Mexico
    New York
    North Carolina
    North Dakota
    Rhode Island
    South Carolina
    South Dakota

    *Disclaimer: Rehab Education LLC provides this list for your convenience. At the time of listing, the following state boards accept courses by virtue of approval by other organizations. It is the responsibility of the participant registering for a course to check with their state board to confirm rules and regulations regarding acceptance of contact hours for live and online courses.

    The following PT Boards accept courses approved by other state PT boards or APTA state associations*:

    North Carolina

    The following PT Boards accept courses approved by other APTA state associations*:

    Rhode Island

    The following PT Boards accept courses provided by AOTA approved providers*:

    District of Columbia
    Rhode Island

    *NBCOT…National Board for Certification of Occupational Therapy (view PDU requirements)

    +HTCC… Hand Therapy Certification Commission  (view recertification requirements)
    Hand Therapy Certification Commission (HTCC): This course is accepted by HTCC towards re-certification.

    State PT Boards
    State OT Boards

7:30 – 8:00am Registration – sign in
8:00 – 8:15

Welcome and Introduction to BFR,

  • general overview of BFR and highlight topics to be covered
8:15 – 9:00

History of BFR and Literature Review

  • BFR’s origins in Japan
  • testing and development of concept
  • review of current research
  • critical appraisal of research identifying current strengths and weaknesses
9:00 – 10:00

Applications of BFR

  • applications of BFR, which can be applied to a wide demographic range.
  • how it can be used as an adjunct to standard training, maintaining fitness during rehabilitation, and in other situations when traditional heavy lifting isn’t possible.
  • Case studies demonstrating global impact on many of the body’s systems.
10:00 – 10:15 Break
10:15 – 11:00

Mechanisms of BFR

  • review anatomy and physiology behind the local and systemic effects resulting from use of BFR.
  • review of vascular effects, disruption of homeostasis, and anabolic response of BFR
11:00 – 12:00

Safety and Efficacy of BFR

  • Indications and contraindications for BFR training
  • research supporting the safety of BFR training will be reviewed and discussed as a group
  • review impacts of cuff design on BFR and how it will alter overall blood pressure.
  • review impact BFR has on muscle, nerve, bone, tendon, and vasculature.
12:00 – 12:30

Safety Demonstrations and Practice

  • B Strong BFR causes no arterial occlusion with maximal inflation
  • compare B Strong to a rigid cuff at rest and with exercise.
  • discussion of doppler ultrasound and limb occlusion pressure
12:30 – 1:30 Lunch
1:30 – 2:00

Efficacy Demonstrations and Practice

  • Participants will perform bilateral lightweight exercise with band around one extremity and not the other. They will be able to experience the disturbance of homeostasis and gain a better understanding of the effect restriction has on the musculoskeletal system with exercise.
2:00 – 3:30

Upper Extremity Exercise, Lower Extremity Exercise, and Total Body Exercise

  • Participants will
    • simulate a clinical scenario of their choice with a partner.
    • analyze and choose appropriate exercise protocols and band inflation pressures.
    • role play: each performing and coaching at least one upper extremity exercise set, one lower extremity exercise set, and one total body exercise set.
3:30 – 3:45 Break
3:45 – 4:30

B Strong App and Q & A

  • learn to utilize the B Strong App personally or for clients. Time will also be given to ask
  • questions and answer session.
4:30 – 5:30

Exam and Closing

  • participants must pass exam with at least a 70%, in order to become certified in HawkGrips BFR
  • summary of key take home points.


Robert Marsico, PT, Ed.D, OCS

Dr. Marsico has been a PT for over 20 years, earning his PT degree from Rutgers University/ UMDNJ. He continued his education and earned a Doctorate in Education in Applied Physiology from Columbia University.  He is an Orthopedic Certified Specialist by the American Board of Physical Therapy Specialties. Rob was an Assistant Professor at Long Island University in 1998, an Assistant Professor at Rutgers/UMDNJ from 1999-2002 and he is currently an Assistant Professor at Stockton University. 

He is the owner of Galloway Orthopedic Physical Therapy- GO PT in Galloway, NJ. He has practiced in the Acute Care and Home Care settings in the past.  In 2015, he was awarded the prestigious James Tucker Excellence in Clinical Practice Award by the APTANJ. He has publications in Medicine and Science in Sports and Exercise, Journal of Spinal Cord Medicine, International Journal of Yoga, American Journal of Physical Medicine and Rehabilitation, and Clinical Cases in Physical Therapy.

He has taught continuing education courses on Instrument Assisted Soft Tissue Mobilization, Interdisciplinary Approach to Orthopedic Care, and Blood Flow Restriction Training.

Classes taught by Robert Marsico: