What question did this study set out to answer?

To investigate how single-chambered versus multi-chambered blood flow restriction cuffs influence exercise volume, cardiovascular responses, and perceived discomfort during sets performed to volitional failure.

November 14, 2024Frontiers in Sports and Active LivingOpen Access

Cardiovascular, perceptual, and performance responses to single- vs. multi-chambered blood flow restriction cuffs

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Why the study?

This study aimed to investigate the impact of blood flow restriction bladder type (single- vs. multi-chambered) on exercise performance, cardiovascular responses, and perceptual experiences during exercise sessions to volitional failure.

Does single-chambered blood flow restriction compared to multi-chambered or no restriction alter exercise performance, cardiovascular responses, and perceptual experiences in healthy active individuals?

Key Points

To investigate how single-chambered versus multi-chambered blood flow restriction cuffs influence exercise volume, cardiovascular responses, and perceived discomfort during sets performed to volitional failure.
Randomized crossover trial (NCT06276673) involving 27 healthy, physically active adults (age: 22.6 ± 5.7 years; 11 females).
Participants performed 4 sets of low-load resistance exercise (20% 1RM) to volitional failure with 1-minute rest intervals under three conditions: single-chamber BFR (SC-BFR at 60% limb occlusion pressure), multi-chamber BFR (MC-BFR at 300 mmHg), and non-BFR control (N-BFR).
SC-BFR blunted post-exercise increases in carotid-femoral pulse wave velocity (+3.3%, p = 0.328), whereas arterial stiffness significantly rose following MC-BFR (+11.8%, p = 0.041) and N-BFR (+9.3%, p = 0.012).
Total repetitions performed were significantly lower in SC-BFR (median: 57 [25–75th percentile: 47–65]) compared to MC-BFR (76 [63–91], p = 0.043) and N-BFR (106 [97–148], p = 0.005).
Discomfort ratings were significantly higher in both SC-BFR (p < 0.001) and MC-BFR (p = 0.035) than in N-BFR, though perceived exertion scores remained similar across all conditions (p = 0.176).

Structured PICO

Population

27 healthy, physically active participants (age: 22.6 ± 5.7; weight: 74.3 ± 15.8 kg; height: 171.7 ± 7.7 cm; BMI: 25.0 ± 4.1 kg/m2; ~93% reported regular resistance training within 6 months; 11 females)

Intervention

Single-chambered blood flow restriction (SC-BFR) using the Delfi Personalized Tourniquet Device inflated to 60% limb occlusion pressure during exercise to failure (4 sets, 20% 1RM, 1 min rest between sets)

Comparator

Multi-chambered blood flow restriction (MC-BFR) using B Strong Cuffs inflated to 300 mmHg, and no blood flow restriction control (N-BFR)

Outcome

Exercise performance (total repetitions), cardiovascular responses (carotid-femoral pulse wave velocity), and perceptual experiences (discomfort, exertion)surrogate

Single-chambered blood flow restriction cuffs mitigate post-exercise arterial stiffness and reduce exercise performance to a greater degree than multi-chambered cuffs or no restriction.

Implication

SC-BFR may accelerate fatigue and blunt post-exercise arterial stiffness more than MC-BFR; leaves optimal cuff selection open for training protocols.

Abstract

Introduction This study aimed to investigate the impact of the blood flow restriction bladder type (single- [SC-BFR] vs. multi-chambered [MC-BFR]) on exercise performance, cardiovascular responses, and perceptual experiences with exercise sessions incorporating multiple sets to volitional failure in a randomized, crossover experimental design. Methods Twenty-seven healthy, physically active participants (age: 22.6 ± 5.7; weight: 74.3 ± 15.8 kg; height: 171.7 ± 7.7 cm; BMI: 25.0 ± 4.1 kg/m2; ∼93% reported regular resistance training within 6 months; 11 females) randomly performed exercise to failure (4× sets to failure, 20% 1RM, 1 min rest between sets) in each of three conditions: SC-BFR (using the Delfi Personalized Tourniquet Device inflated to 60% limb occlusion pressure), MC-BFR (using the B Strong Cuffs inflated to 300 mmHg according to manufacturer recommendations), and N-BFR (no BFR control). Results SC-BFR blunted post-exercise increases in carotid-femoral pulse wave velocity ( p = 0.328) (+3.3%) whereas the other conditions showed elevations (MC-BFR +11.8% [ p = 0.041], N-BFR +9.3% [ p = 0.012]). Discomfort was lower in N-BFR compared to SC-BFR ( p < 0.001) and MC-BFR ( p = 0.035) but all displayed similar exertion ( p = 0.176). Median total repetitions achieved were significantly less in SC-BFR (57 [25–75th percentile: 47–65) than MC-BFR (76 [63–91] ( p = 0.043) and N-BFR [106 (97–148)] p = 0.005). Per set repetition volumes were similar on set 1 between SC-BFR ( p < 0.001) and MC-BFR ( p = 0.001) and were lower than N-BFR ( p ≤ 0.001) whereas in sets 2–4, MC-BFR performed similar number of repetitions as N-BFR ( p = 0.984–1.000). Conclusion Bladder design of a BFR cuff has an impact on the acute responses to exercise if applied according to recommended application guidelines, as SC-BFR impacts performance to a greater degree and mitigates post-exercise arterial stiffness responses compared to MC-BFR and N-BFR while both BFR conditions display greater levels of discomfort compared to N-BFR. Clinical Trial Registration NCT06276673.