Acute neuromuscular and short-term recovery responses to low-load exercise with individualized blood flow restriction in elite male volleyball players

Blood flow restriction (BFR) training is widely used to augment the effects of low-load resistance exercise, yet the influence of individualized BFR intensity on acute neuromuscular responses and early recovery remains incompletely understood, particularly in elite athletes. This study examined acute neuromuscular, morphological, and tolerability responses to low-load leg press exercise performed under individualized BFR conditions in elite male volleyball players. Thirty-three athletes completed four repeated exercise sessions at 0%, 40%, 60%, and 80% of arterial occlusion pressure. Vastus lateralis surface electromyography and ultrasound-derived muscle thickness were assessed before exercise and during the first 30 min of post-exercise recovery under standardized conditions. Session RPE, cuff-related discomfort/pain, and paresthesia were also recorded. Linear mixed-effects models were used for neuromuscular and morphological outcomes, and appropriate repeated-measures non-parametric tests were used for tolerability outcomes. Low-load exercise with individualized BFR elicited acute changes in neuromuscular and morphological indices. Higher occlusion pressures were associated with small but statistically detectable overall differences in response magnitude when responses were averaged across time. In contrast, recovery profiles over the first 30 min after exercise were comparable across restriction levels, consistent with the absence of condition-dependent time-course effects. All athletes completed all four conditions; however, tolerability worsened as occlusion pressure increased, with higher session RPE and more frequent cuff-related discomfort/pain and paresthesia at higher pressures. In elite male volleyball players, variation in individualized BFR intensity appears to influence the overall magnitude of acute responses more than the short-term recovery trajectory itself. The present data do not provide evidence that higher occlusion pressures confer superior short-term recovery characteristics in this elite cohort. Because tolerability worsened as occlusion pressure increased, pressure selection in applied settings should balance physiological stimulus against symptom burden.