What is the clinical evidence from this study?

Study design: RCT. Population: Advanced level climbers (n=22). Intervention: Low load blood flow restriction (LL-BFR) resistance training vs. High load (HL) resistance training (75% of MVC, 3 sets to failure, twice per week). Primary outcome: Maximal voluntary isometric contraction (MVC) of the finger flexors (ηp2 0.029, p=0.498).

April 24, 2026Open Access

Comparison of low load blood flow restriction and high load resistance training of the finger flexors in advanced level climbers: a pilot study

Key Result

Low load blood flow restriction and high load resistance training of the finger flexors resulted in no significant between-group differences, with both interventions similarly improving maximal strength, hypertrophy, and climbing performance.

Study Design

Type

RCT (n=22)

Randomization

Randomly allocated

Multicenter

Structured PICO

Does low load blood flow restriction training improve finger flexor strength, hypertrophy, and climbing performance compared to high load resistance training in advanced level climbers?

Population

22 advanced-level climbers (mean age ~27 years, 9% female) free of recent injuries, randomized to 5 weeks of finger flexor resistance training with either low load blood flow restriction or high load.

Intervention

Low load blood flow restriction (LL-BFR) resistance training of the finger flexors (40% of MVC, 3 sets to failure, cuffs inflated to 60% of full arterial restriction), twice per week for 5 weeks.

Comparator

High load (HL) resistance training of the finger flexors without BFR (75% of MVC, 3 sets to failure), twice per week for 5 weeks.

Outcome

Isometric pull-up (peak- and average force), maximal voluntary contraction (MVC) in a finger flexor exercise, finger endurance, forearm circumference, and climbing performance at 5 weeks.surrogate

Low load blood flow restriction training is a viable alternative to high load resistance training for improving maximal strength, forearm hypertrophy, and climbing performance in advanced climbers.

Main Result

Effect estimate: ηp2 0.029

Absolute Event Rate: 93.1% vs 107.2%

p-value: p=0.498

Limitations

Pilot study without an a priori sample size calculation, potentially underpowered to detect between-group differences.
High dropout rate (27%) in the LL-BFR group due to perceived discomfort, introducing potential attrition bias.
Skewed sex-ratio with only two female participants included.
Short intervention duration of only five weeks.
Lack of familiarization sessions before pre-tests, potentially introducing a learning effect.
Climbing test route was not differentiated to match individual participant levels.

Abstract

Introduction: The aim of the present pilot study was to compare the effects of low load blood flow restriction (LL-BFR) with high load resistance training (HL) in advanced level climbers. Methods: Twenty-two climbers were randomly allocated to LL-BFR or HL performing training twice per week for five weeks. Before and after the intervention the participants were tested in isometric pull-up (peak- and average force), maximal voluntary contraction (MVC) in a finger flexor exercise, finger endurance, forearm circumference, and climbing performance. Results: There were no group differences in any of the tests (p=0.346-0.891), however, both groups increased their average force in the pull-up (LL-BFR; 52 N, p=0.012, HL; 56 N, p=0.024), MVC (LL-BFR; 15 kg, p=0.008, HL; 17 kg, p=0.002), forearm circumference (LL-BFR; 0.8 cm, p=0.012, HL; 0.6, p=0.038) and climbing performance (LL-BFR; 13.5 moves, p=0.012, HL; 10 moves, p=0.003). No pre-post differences were observed for the peak force in the pull-up (p=0.132-0.376) or the endurance test (p=0.752-1.000). Discussion: In conclusion, resistance training of the finger flexors with HL or LL-BFR resulted in no between-group differences, with both interventions improving maximal strength, hypertrophy, and climbing performance, but not endurance.

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