Key result
In fixed repetition schemes, resistance exercise with blood flow restriction promoted higher perceived exertion (SMD 1.04; P<0.01) and discomfort (SMD 1.10; P<0.01) than non-BFR low-load exercise.
Why the study?
Studies comparing perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise had yielded contradictory results.
Does resistance exercise with blood flow restriction alter rate of perceived exertion and muscle discomfort compared to traditional resistance exercise?
Meta-Analysis
Does resistance exercise with blood flow restriction alter rate of perceived exertion and muscle discomfort compared to traditional resistance exercise?
Standardized Mean Difference: 1.04
p-value: p=<0.01
Resistance exercise with blood flow restriction promotes higher perceived exertion and discomfort than low-load resistance exercise without restriction in fixed repetition schemes.
RE+BFR raises RPE versus low-load exercise; confirms greater perceptual demand and supports tolerance monitoring in rehab protocols.
Context: Several studies have compared perceptual responses between resistance exercise with blood flow restriction and traditional resistance exercise (non-BFR). However, the results were contradictory. Objectives: To analyze the effect of RE+BFR versus non-BFR resistance exercise [low-load resistance exercise (LL-RE) or high-load resistance exercise (HL-RE)] on perceptual responses. Data Sources: CINAHL, Cochrane Library, PubMed ® , Scopus, SPORTDiscus, and Web of Science were searched through August 28, 2021, and again on August 25, 2022. Study Selection: Studies comparing the effect of RE+BFR versus non-BFR resistance exercise on rate of perceived exertion (RPE) and muscle pain/discomfort were considered. Meta-analyses were conducted using the random effects model. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 2. Data Extraction: All data were reviewed and extracted independently by 2 reviewers. Disagreements were resolved by a third reviewer. Results: Thirty studies were included in this review. In a fixed repetition scheme, the RPE [standardized mean difference (SMD) = 1.04; P < 0.01] and discomfort (SMD = 1.10; P < 0.01) were higher in RE+BFR than in non-BFR LL-RE, but similar in sets to voluntary failure. There were no significant differences in RPE in the comparisons between RE+BFR and non-BFR HL-RE; after sensitivity analyses, it was found that the RPE was higher in non-BFR HL-RE in a fixed repetition scheme. In sets to voluntary failure, discomfort was higher in RE+BFR versus non-BFR HL-RE (SMD = 0.95; P < 0. 01); however, in a fixed scheme, the results were similar. Conclusion: In sets to voluntary failure, RPE is similar between RE+BFR and non-BFR exercise. In fixed repetition schemes, RE+BFR seems to promote higher RPE than non-BFR LL-RE and less than HL-RE. In sets to failure, discomfort appears to be similar between LL-RE with and without BFR; however, RE+BFR appears to promote greater discomfort than HL-RE. In fixed repetition schemes, the discomfort appears to be no different between RE+BFR and HL-RE, but is lower in non-BFR LL-RE.
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Queirós et al. (2022) reported a meta-analysis. Resistance exercise with blood flow restriction (RE+BFR) vs. Non-BFR resistance exercise (low-load or high-load) was evaluated on Rate of perceived exertion (RPE) in a fixed repetition scheme vs non-BFR LL-RE (SMD 1.04, p=<0.01). In fixed repetition schemes, resistance exercise with blood flow restriction promoted higher perceived exertion (SMD 1.04; P<0.01) and discomfort (SMD 1.10; P<0.01) than non-BFR low-load exercise.
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