We examined muscle activation during low-intensity muscle contractions with a moderate restriction of blood flow and complete occlusion of blood flow. Unilateral elbow flexion muscle contractions (20% of 1-RM) were performed in Experiment 1 (30 contractions), Experiment 2 (3 sets × 10 contractions), and Experiment 3 (30 repetitive contractions followed by 3 sets × 15 contractions) with moderate restriction, complete occlusion of blood flow or unrestricted blood flow (control). Electromyography (EMG) was recorded from surface electrodes placed on the biceps brachii muscle and the integrated EMG (iEMG) and mean power frequency (MPF) obtained. During Experiments 1 and 2, muscle activation was progressively increased in complete occlusion and moderate restriction of blood flow to levels greater than in the control. The decline in maximal voluntary isometric contraction (MVC) following the bout of contractions was greater with complete occlusion (39–48%) than moderate restriction of blood flow (16–19%); control MVC did not change. In Experiment 3, changes in MVC, iEMG, and MPF were greater with moderate restriction of blood flow than in the control but comparable with complete occlusion of blood flow where less total work was performed. In conclusion, moderate restriction of blood flow results in similar neural manifestations in muscle as complete occlusion of blood flow but without the apparent contractile/metabolic impairment observed with complete occlusion. Thus, low-intensity muscle contractions, with moderate restriction of blood flow, leads to more intense activation of the muscle relative to the external load.

We investigated the acute and chronic effects of low-intensity concentric or eccentric resistance training with blood flow restriction (BFR) on muscle size and strength. Ten young men performed 30% of concentric one repetition maximal dumbbell curl exercise (four sets, total 75 reps) 3 days/week for 6 weeks. One arm was randomly chosen for concentric BFR (CON-BFR) exercise only and the other arm performed eccentric BFR (ECC-BFR) exercise only at the same exercise load. During the exercise session, iEMG for biceps brachii muscles increased progressively during CON-BFR, which was greater (p<0.05) than that of the ECC-BFR. Immediately after the exercise, muscle thickness (MTH) of the elbow flexors acutely increased (p<0.01) with both CON-BFR and ECC-BFR, but was greater with CON-BFR (11.7%) (p<0.01) than ECC-BFR (3.9%) at 10-cm above the elbow joint. Following 6-weeks of training, MRI-measured muscle cross-sectional area (CSA) at 10-cm position and mid-upper arm (12.0% and 10.6%, respectively) as well as muscle volume (12.5%) of the elbow flexors were increased (p<0.01) with CON-BFR. Increases in muscle CSA and volume were lower in ECC-BFR (5.1%, 0.8% and 2.9%, respectively) than in the CON-BFR and only muscle CSA at 10-cm position increased significantly (p<0.05) after the training. Maximal voluntary isometric strength of elbow flexors was increased (p<0.05) in CON-BFR (8.6%), but not in ECC (3.8%). These results suggest that CON-BFR training leads to pronounced acute changes in muscle size, an index of muscle cell swelling, the response to which may be an important factor for promoting muscle hypertrophy with BFR resistance training.

We examined the effects of walk training combined with leg blood flow reduction (BFR) on muscle hypertrophy as well as on peak oxygen uptake (VO_2peak) in older individuals. Both the BFR walk training (BFR-Walk, n = 10, age; 64 ± 1 years, body mass index [BMI]; 22.5 ± 0.9 kg/m²) and control walk training (CON-Walk, n = 8, age; 68 ± 1 years, BMI; 23.2 ± 1.0 kg/m²) groups performed 20 minutes of treadmill walking at an exercise intensity of 45% of heart rate reserve, 4 days per week, for 10 weeks. The BFR-Walk group wore pressure belts (160–200 mm Hg) on both legs during training. After the training, magnetic resonance imaging–measured thigh muscle cross-sectional area (3.1%, p < .01) and muscle volume (3.7%, p < .01) as well as maximal isometric (5.9%, p < .05) and isokinetic (up to 22%, p < .01) strength increased in the BFR-Walk group, but not in the CON-Walk group. Estimated VO_2peak during a bicycle graded exercise test increased (p < .05) and correlated with oxygen pulse in both groups. In conclusion, BFR walk training improves both muscle volume and strength in older women.