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March 28, 2026BMC Sports Science Medicine and Rehabilitation2 citationsOpen Access

The effect of blood flow restriction resistance exercise on arm muscle strength and isokinetic contraction parameters

HKHüsnü KOCAMANLALatif Aydos

Key Result

Low-load blood flow restriction training produced similar improvements in upper-extremity isokinetic peak torque (right arm extension +4% vs +9%, p=0.478) compared to high-load resistance training.

Key Points

  • To compare the effects of low-load blood flow restriction training (LL-BFRT) and high-load resistance training (HL-RT) on arm muscle strength.
  • Randomly allocated 22 male participants to LL-BFRT or HL-RT groups
  • LL-BFRT performed at 30% of 1RM with arterial occlusion; HL-RT at 70% of 1RM
  • Both groups performed biceps curls and triceps pushdowns twice weekly for 7 weeks
  • Isokinetic strength measured pre- and post-training using dynamometry
  • Used two-way repeated measures ANOVA for statistical analysis.
  • Both groups showed significant improvements in isokinetic strength parameters
  • No significant difference between groups for peak torque
  • Both groups increased total work with LL-BFRT +16.3% and HL-RT +8.4%
  • LL-BFRT also showed a 19% increase in left arm flexion relative strength
  • No adverse events were reported.

Study Design

Type

RCT (n=22)

Blinding

Open-label

Randomization

Simple random allocation

Multicenter

No

Structured PICO

Does low-load blood flow restriction training improve arm muscle strength compared to high-load resistance training in healthy male adults?

P
Population
Healthy male adults aged 18-40 who had been performing resistance training regularly for at least six months
I
Intervention
Low-load blood flow restriction training (LL-BFRT) at 30% of 1RM (4 sets; 30-15-15-15 repetitions) with progressive arterial occlusion pressure (30-50%)
C
Comparator
High-load resistance training (HL-RT) at 70% of 1RM (3 sets; 10-12 repetitions)
O
Outcome
Isokinetic muscle strength outcomes (peak torque, relative strength, and total work) and maximal muscle strength (1RM)surrogate

Low-load blood flow restriction training induces meaningful strength gains comparable to high-load resistance training, supporting its use as a safe alternative when high loads are not feasible.

Main Result

Effect estimate: η² 0.049

Absolute Event Rate: 4% vs 9%

p-value: p=0.478

Limitations

  • Small sample size
  • Short duration of the study
  • Limited statistical power to detect small-to-moderate between-group differences
  • Baseline differences in age and body fat percentage
  • small sample size
  • short duration of the study
  • limited statistical power to detect small-to-moderate between-group differences

Abstract

While high-load resistance training (HL-RT) is well established as an effective method for improving muscle strength, low-load blood flow restriction training (LL-BFRT) has been suggested to induce similar neuromuscular adaptations while imposing substantially lower mechanical stress. However, direct comparative evidence between LL-BFRT and HL-RT in the upper limbs remains limited. Twenty-two healthy male participants (age: 26.3 ± 7.2 years, range:18–40, height: 176.9 ± 6.5 cm; body mass: 77.9 ± 13.5 kg) were randomly allocated to either LL-BFRT (n = 12) or HL-RT (n = 10). The LL-BFRT group trained at 30% of 1RM (4 sets; 30-15-15-15 repetitions) with progressive arterial occlusion pressure (30–50%), while the HL-RT group trained at 70% of 1RM (3 sets; 10–12 repetitions). Both groups, within their redesigned and equalised training programs, performed biceps curls and triceps pushdowns twice weekly for 7 weeks. Isokinetic muscle strength outcomes, including peak torque, relative strength, and total work, were assessed using isokinetic dynamometry (Isomed 2000, 60°/s). Maximal muscle strength outcomes included one-repetition maximum (1RM) strength. Statistical analyses were performed using two-way repeated measures ANOVA with Bonferroni corrections, reporting effect sizes (η²) and 95% confidence intervals (CI). Both groups demonstrated significant pre- and post-improvements in isokinetic strength parameters (p < 0.05). No significant group × time interaction was observed for peak torque (right arm extension: LL-BFRT + 4%, HL-RT + 9%; p = 0.478, η²=0.049). Both groups showed within-group increases in total work (LL-BFRT right arm + 16.3%, HL-RT + 8.4%) and relative strength (LL-BFRT left arm flexion + 19.0%, HL-RT + 10.6%). No adverse events were reported. Preliminary evidence suggests that LL-BFRT can induce meaningful strength gains in healthy adults. These findings support LL-BFRT as a safe and potentially effective training alternative when high loads are not feasible, particularly in rehabilitation contexts. However, the small sample size and short duration of the study limit the generalizability of the results. Future studies with larger samples and extended follow-up periods are needed to confirm and expand upon these findings. These findings should be interpreted cautiously due to the limited statistical power to detect small-to-moderate between-group differences. ClinicalTrials.gov, NCT07462520. Registered 5 March 2026.

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Cite This Study

KOCAMAN et al. (2026) conducted an RCT in Healthy adults (n=22). Low-load blood flow restriction training (LL-BFRT) vs. High-load resistance training (HL-RT) at 70% of 1RM was evaluated on Peak torque (right arm extension) (η² 0.049, p=0.478). Low-load blood flow restriction training produced similar improvements in upper-extremity isokinetic peak torque (right arm extension +4% vs +9%, p=0.478) compared to high-load resistance training.

synapsesocial.com/papers/69c771348bbfbc51511e109bhttps://doi.org/10.1186/s13102-026-01658-0
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