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Comparative study of high- and low-load blood flow restriction training on strength, hypertrophy, aerobic capacity, and fatigue in athletes

In: Comparative Exercise Physiology
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S.R. Ghanim College of Physical Education and Sports Sciences, Samarra University, Sallah Adlen, Iraq

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https://orcid.org/0009-0002-2536-4049
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I.S. Mahmood College of Physical Education and Sports Sciences, Samarra University, Sallah Adlen, Iraq

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https://orcid.org/0009-0009-9569-4722
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S.A. Mohammed College of Physical Education and Sports Sciences, Samarra University, Sallah Adlen, Iraq

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https://orcid.org/0000-0002-6447-8244
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M.K. Ahmed College of Physical Education and Sports Sciences, Kirkuk University, Kirkuk, Iraq

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https://orcid.org/0009-0000-6077-4356
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Abstract

Blood flow restriction (BFR) training has been shown to induce muscle and cardiovascular adaptations at lower loads, yet the comparative effects of high- versus low-intensity BFR remain unclear. This study investigated whether high-load BFR (HL-BFR) and low-load BFR (LL-BFR) differentially affect strength, hypertrophy, aerobic capacity, and fatigue markers in trained athletes. In a randomized trial, n = 24 male athletes were allocated to HL-BFR (70-80% 1RM with 40-60% arterial occlusion pressure, AOP), LL-BFR (20-30% 1RM with 60-80% AOP), or a control group performing conventional training for 8 weeks. Outcomes included one-repetition maximum (1RM), thigh cross-sectional area (CSA) measured by ultrasound, maximal oxygen uptake (VO2max), blood lactate levels, and rating of perceived exertion (RPE). Data were analysed using repeated-measures ANOVA with Tukey post hoc tests and effect sizes (η2p). Significant group × time interactions were observed across all outcomes (all P < 0.01). HL-BFR elicited the most significant gains in 1RM (+22.5 ± 4.2 kg) and CSA (+4.8 ± 1.2 cm2), whereas LL-BFR produced the most essential improvements in VO2max (+4.1 ± 1.0 ml/kg ⋅ min) and the most significant reductions in lactate (−2.3 ± 0.6 mmol/l) and RPE (−2.1 ± 0.6). Both BFR groups outperformed control (all P < 0.05). BFR training enhances both muscular and aerobic adaptations, with HL-BFR being most effective for hypertrophy and strength, and LL-BFR being most effective for endurance-related outcomes. These findings underscore the comparative physiological relevance of BFR across intensities and highlight its translational value in human and potentially animal exercise physiology.

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