Impact of Low- and High-Pressure Blood Flow Restriction on Muscle Strength and Neuromuscular Control

Ing-Shiou Hwang, Chia-Chan Wu, Yi-Ching Chen
Purpose:

This study aimed to contrast the training effects of BFR at low-pressure and high-pressure settings and to compare performance during various intensities of force-tracking tasks.

Methods:

Eighteen healthy subjects were randomly assigned to the low-pressure (LP, 60% systolic pressure (SBP), n = 9) and high-pressure (HP, 90% SBP, n = 9) groups. The strength training protocol involved voluntary non-dominant wrist extension with BFR, consisting of 30-30-20-20-20 repetitions with 1-minute rests between sets, three times a week, totaling nine sessions over three weeks. Pre-test and post-test measures included maximal voluntary contraction (MVC) and trapezoidal force tracking during isometric wrist extension at low-load (LL, 0%-30%-0% MVC) and high-load (HL, 0%-60%-0% MVC). The normalized difference in force variables was defined as (post-test – pre-test)/pre-test.

Results:

Both groups showed no difference in the normalized difference of MVC (p = 0.789), although both experienced increases in MVC after BFR training. However, the groups exhibited different patterns in the normalized difference in force fluctuations during trapezoidal force tracking. Comparison of normalized differences between BFR pressure settings and task intensity revealed interaction effects (p = 0.017). A significant difference in simple main effects was observed only in the LL (30% MVC) force tracking task, where the LP group demonstrated a significantly larger normalized difference in RMS decrement (-14.38 ± 13.98%) compared to the HP group (2.68 ± 14.95%) (p = 0.024).

Conclusion(s):

Both low and high-pressure BFR training protocols led to comparable improvements in MVC. However, the pressure settings had differential effects on force scaling. Low-pressure BFR resulted in a significantly greater reduction in RMS force fluctuations during low-load tasks compared to high-pressure BFR, suggesting that low-pressure BFR may be more effective in enhancing neuromuscular control for fine force regulation.

Implications:

Low-pressure BFR may be more advantageous for skilled motor control that requires precision and stability, offering an alternative rehabilitation strategy for patients recovering from neuromuscular injuries.

Funding acknowledgements:
Supported by grants from the Ministry of Science and Technology, Taiwan, R.O.C. The authors have no conflict of interest.
Keywords:
Blood Flow Restriction
Muscle Strength
Neuromuscular Control
Primary topic:
Health promotion and wellbeing/healthy ageing/physical activity
Second topic:
Other
Third topic:
Sport and sports injuries
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Institutional Review Board of National Cheng Kung University Hospital
Provide the ethics approval number:
B-ER-109-472
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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