Blood Flow Restriction Does Not Promote Additional Effects on Muscle Adaptations When Combined With High-Load Resistance Training Regardless of Blood Flow Restriction Protocol

Abstract

Teixeira, EL, Ugrinowitsch, C, de Salles Painelli, V, Silva-Batista, C, Aihara, AY, Cardoso, FN, Roschel, H, and Tricoli, V. Blood flow restriction does not promote additional effects on muscle adaptations when combined with high-load resistance training regardless of blood flow restriction protocol. J Strength Cond Res 35(5): 1194–1200, 2021—The aim of this study was to investigate, during high-load resistance training (HL-RT), the effect of blood flow restriction (BFR) applied during rest intervals (BFR-I) and muscle contractions (BFR-C) compared with HL-RT alone (no BFR), on maximum voluntary isometric contraction (MVIC), maximum dynamic strength (one repetition maximum [1RM]), quadriceps cross-sectional area (QCSA), blood lactate concentration ([La]), and root mean square of the surface electromyography (RMS-EMG) responses. Forty-nine healthy and untrained men (25 ± 6.2 years, 178.1 ± 5.3 cm and 78.8 ± 11.6 kg) trained twice per week, for 8 weeks. One leg of each subject performed HL-RT without BFR (HL-RT), whereas the contralateral leg was randomly allocated to 1 of 2 unilateral knee extension protocols: BFR-I or BFR-C (for all protocols, 3 × 8 repetitions, 70% 1RM). Maximum voluntary isometric contraction, 1RM, QCSA, and acute changes in [La] and RMS-EMG were assessed before and after training. The measurement of [La] and RMS-EMG was performed during the control sessions with the same relative load obtained after the 1RM test, before and after training. Similar increases in MVIC, 1RM, and QCSA were demonstrated among all conditions, with no significant difference between them. [La] increased for all protocols in pre-training and post-training, but it was higher for BFR-I compared with the remaining protocols. Increases in RMS-EMG occurred for all protocols in pre-training and post-training, with no significant difference between them. In conclusion, despite of a greater metabolic stress, BFR inclusion to HL-RT during rest intervals or muscle contraction did not promote any additive effect on muscle strength and hypertrophy.

Effect of low‐intensity exercise with blood flow restriction during rest intervals on muscle function and perception

“…Pressure volume in the present study was 120 mmHg, which was approximately 90%-100% of the arterial blood pressure. Previous studies examining BFR during rest intervals have been conducted on approximately 80%-130% (about 90-180 mmHg) of arterial or dorsal blood pressure (Okita et al, 2019;Schwiete et al, 2021;Teixeira et al, 2018Teixeira et al, , 2021; pressure volume did not differ significantly thus in this study. It is, therefore, expected that pain will be alleviated by lowering pressure volume in BFR during rest intervals.…”

“…Recent studies have been establishing a novel BFR approach during rest intervals. BFR during rest intervals has been shown to be comparable to continuous BFR or BFR during exercise regarding its effects on maximum muscle strength, muscle hypertrophy, muscle endurance while causing less pain or discomfort (Schwiete et al, 2021; Teixeira et al, 2021). BFR during rest intervals is a beneficial approach of BFR training as it induces training effects without affecting the exerciser adversely.…”

Acute muscular and cardiovascular responses to high load training with pre‐exercise blood flow restriction

“…The inclusion of BFR to resistance training regimens has predominantly been utilized with low‐load resistance exercise (Dankel et al, 2016b; Farup et al, 2015). Some research groups have also investigated the concept of applying BFR to high‐load resistance exercise, to potentially maximize the benefits (enhanced metabolic stress and increased mechanical tension) that both forms of training provide on their own (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021). Findings from these interventions have indicated applying BFR to high‐load resistance exercise has no added benefits when compared with high‐load training on its own (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021).…”

“…Some research groups have also investigated the concept of applying BFR to high‐load resistance exercise, to potentially maximize the benefits (enhanced metabolic stress and increased mechanical tension) that both forms of training provide on their own (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021). Findings from these interventions have indicated applying BFR to high‐load resistance exercise has no added benefits when compared with high‐load training on its own (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021). The ineffectiveness of BFR when combined with high‐load resistance exercise could be a result of the methodologies applied during the training protocols (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021).…”

“…Findings from these interventions have indicated applying BFR to high‐load resistance exercise has no added benefits when compared with high‐load training on its own (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021). The ineffectiveness of BFR when combined with high‐load resistance exercise could be a result of the methodologies applied during the training protocols (Dankel et al, 2016a; Laurentino et al, 2008; Teixeira et al, 2021). Laurentino et al (2008) examined muscle growth following unilateral knee extension for three to five sets of either a 6RM (~80%1RM) or 12RM (~60%1RM) with or without intermittent vascular occlusion.…”