The Effects of Restriction Pressure on Muscle Damage Responses to Blood Flow Restriction Exercise

NCT05037942 | Completed

• 1 other identifier: FHMS 20-21 151 EGA
• Study Type: interventional
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

Blood flow restriction (BFR) exercise involves the application of a constriction device to the limbs to restrict muscle blood flow during exercise. In recent years, BFR has become increasingly popular due to its additive effects on low-load resistance training, often promoting greater increases in muscle strength and size compared to similar resistance training without BFR. However, like other exercise, it is possible that BFR exercise can cause exercise-induced muscle damage (EIMD) that results in short-term reductions in muscle function and increased muscle soreness and swelling. One major variable that may influence the onset of EIMD is the restriction pressure used to restrict blood flow; however, the influence of restriction pressure on resistance EIMD is unclear. The purpose of this study is to investigate effects of two different restriction pressures (low and high) on EIMD responses to a bout of low-load BFR resistance exercise in a sample of healthy, active adults. It is hypothesised that a higher restriction pressure will result in increased EIMD compared to a lower restriction pressure. To test this hypothesis, participants will perform a lower-body exercise protocol with and without BFR, and several markers of EIMD will be assessed before and immediately, 24, 48, and 72 hours after the exercise.

Conditions

Muscle Damage; Muscle Soreness; Muscle Strength

Keywords

Muscle Damage; Muscle Soreness; Muscle Strength; Blood Flow Restriction

Outcome Measures

Primary Outcomes (1)

• Mean change in maximal voluntary isometric force of the knee extensors from pre-intervention up to 72 hours post-intervention

  The change in the maximum amount of voluntary isometric force produced by the knee extensors, assessed via a series of maximal voluntary contractions performed at 90 degrees of knee flexion (extension = 0 degrees).

  Immediately pre-intervention, immediately post-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

Secondary Outcomes (5)

• Mean change in the joint angle-torque curve of the knee extensors from pre-intervention up to 72 hours post-intervention

  Immediately pre-intervention, immediately post-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

• Mean change in plasma creatine kinase from pre-intervention up to 72 hours post-intervention

  Immediately pre-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

• Mean change in pain-free range of motion of the knee extensors from pre-intervention up to 72 hours post-intervention

  Immediately pre-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

• Mean change in muscle thickness of the rectus femoris and vastus lateralis from pre-intervention up to 72 hours post-intervention

  Immediately pre-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

• Mean change in perceived muscle soreness from pre-intervention up to 72 hours post-intervention

  Immediately pre-intervention, 24 hours post-intervention, 48 hours post-intervention, 72 hours post-intervention

Study Arms (4)

Blood flow-restricted exercise at 40% limb occlusion pressure (BFR-40)

EXPERIMENTAL

Participants in BFR-40 will perform a lower-body exercise protocol under BFR set to 40% of the participants' relative limb occlusion pressure.

Other: Blood flow restriction at 40% limb occlusion pressure

Blood flow-restricted exercise at 80% limb occlusion pressure (BFR-80)

EXPERIMENTAL

Participants in BFR-80 will perform the same lower-body BFR exercise protocol as BFR-40; however, the occlusion pressure will be set to 80% of the participants' relative limb occlusion pressure.

Other: Blood flow restriction at 80% limb occlusion pressure

Control for BFR-40

NO INTERVENTION

Participants randomised to BFR-40 will perform the same exercise protocol without BFR with the contralateral leg.

Control for BFR-80

NO INTERVENTION

Participants randomised to BFR-80 will perform the same exercise protocol without BFR with the contralateral leg.

Interventions

Blood flow restriction at 40% limb occlusion pressure OTHER

A 13-cm-wide pneumatic cuff will be applied to the most proximal portion of the chosen thigh (as determined by randomisation), immediately distal to the inguinal fold, prior to a bout of lower-body resistance exercise. The cuff will be inflated to 40% of limb occlusion pressure pressure and will remain inflated throughout the exercise (total occlusion time: \~5 mins).

Also known as: Vascular restriction, Vascular occlusion, Venous restriction

Blood flow-restricted exercise at 40% limb occlusion pressure (BFR-40)

Blood flow restriction at 80% limb occlusion pressure OTHER

A 13-cm-wide pneumatic cuff will be applied to the most proximal portion of the chosen thigh (as determined by randomisation), immediately distal to the inguinal fold, prior to a bout of lower-body resistance exercise. The cuff will be inflated to 80% of limb occlusion pressure pressure and will remain inflated throughout the exercise (total occlusion time: \~5 mins).

Also known as: Vascular restriction, Vascular occlusion, Venous restriction

Blood flow-restricted exercise at 80% limb occlusion pressure (BFR-80)

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Recreationally active (defined as performing ≥ 150 minutes of moderate-intensity or ≥ 75 minutes of vigorous-intensity exercise per week for the past 6 months)
• Resistance-untrained (defined as performing less than 2 resistance exercise sessions per week for the past 6 months)

You may not qualify if:

• Any history of cardiovascular (including hypertension \[diastolic \> 90 and/or systolic blood pressure \> 140 mmHg\] and peripheral arterial vascular disease), metabolic, respiratory (including severe asthma), haematological (including deep vein thrombosis and pulmonary embolism), neurological, gastrointestinal, kidney, liver, or musculoskeletal disease
• Current or previous musculoskeletal injury that may be aggravated by exercise
• Current smoker
• Recently used prescribed anti-inflammatory medication within the previous 1 month
• Self-reported or diagnosed menstrual irregularities within ≥ 3 months prior to recruitment
• Currently pregnant

Sponsors & Collaborators

• University of Surrey: lead

Study Sites (1)

University of Surrey

Guildford, Surrey, GU2 7XH, United Kingdom

Location

Related Publications (4)

• Patterson SD, Hughes L, Warmington S, Burr J, Scott BR, Owens J, Abe T, Nielsen JL, Libardi CA, Laurentino G, Neto GR, Brandner C, Martin-Hernandez J, Loenneke J. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Front Physiol. 2019 May 15;10:533. doi: 10.3389/fphys.2019.00533. eCollection 2019.

  PMID: 31156448 BACKGROUND

• Lixandrao ME, Ugrinowitsch C, Berton R, Vechin FC, Conceicao MS, Damas F, Libardi CA, Roschel H. Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis. Sports Med. 2018 Feb;48(2):361-378. doi: 10.1007/s40279-017-0795-y.

  PMID: 29043659 BACKGROUND

• de Queiros VS, Dos Santos IK, Almeida-Neto PF, Dantas M, de Franca IM, Vieira WHB, Neto GR, Dantas PMS, Cabral BGAT. Effect of resistance training with blood flow restriction on muscle damage markers in adults: A systematic review. PLoS One. 2021 Jun 18;16(6):e0253521. doi: 10.1371/journal.pone.0253521. eCollection 2021.

  PMID: 34143837 BACKGROUND

• Hyldahl RD, Hubal MJ. Lengthening our perspective: morphological, cellular, and molecular responses to eccentric exercise. Muscle Nerve. 2014 Feb;49(2):155-70. doi: 10.1002/mus.24077. Epub 2013 Dec 3.

  PMID: 24030935 BACKGROUND

MeSH Terms

Conditions

Myalgia

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Diseases; Nervous System Diseases; Musculoskeletal Pain; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Kyle Gapper

  University of Surrey

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Given the perceptual response that occurs under different occlusion pressures, it is difficult to mask the participant to the experimental conditions. Efforts will be made to minimise detection bias by blinding the outcome assessor to the study conditions and the timepoints from which the data has been collected.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: The study uses a within-between, unilateral design, in which participants will be randomly allocated into one of two experimental groups using a stratified random allocation technique. Each group will perform blood flow-restricted exercise with one leg and the same exercise protocol without BFR with the contralateral leg. Experimental groups will be differentiated by the tourniquet pressure used during the BFR condition: i) tourniquet pressure set to 40% of limb occlusion pressure or ii) tourniquet pressure set to 80% of limb occlusion pressure. Legs will be counterbalanced such that the BFR and control conditions in each study group contain an equal number of dominant and non-dominant legs. This study design allows comparison between the two experimental conditions (i.e., 40% vs. 80% limb occlusion pressure), while allowing participants to serve as their own control condition.

Study Record Dates

• First Submitted: August 31, 2021
• First Posted: September 8, 2021
• Study Start: November 29, 2021
• Primary Completion: June 28, 2022
• Study Completion: June 28, 2022
• Last Updated: December 26, 2023

Record last verified: 2023-12

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)