The current manuscript sets out a series of guidelines for blood flow restriction exercise, focusing on the methodology, application and safety of this mode of training. With the emergence of this technique and the wide variety of applications within the literature, the aim of this review is to set out a current research informed guide to blood flow restriction training to practitioners. This covers the use of blood flow restriction to enhance muscular strength and hypertrophy via training with resistance and aerobic exercise and preventing muscle atrophy using the technique passively. The authorship team for this article was selected from the researchers focused in blood flow restriction training research with expertise in exercise science, strength and conditioning and sports medicine.

The aim of this study was to compare the acute effect of resistance exercise (RE) with and without blood flow restriction (BFR) on heart rate (HR), double product (DP), oxygen saturation (SpO2 ) and rating of perceived exertion (RPE). Twenty-four men (21·79 ± 3·21 years) performed three experimental protocols in a random order (crossover): (i) high-intensity RE at 80% of 1RM (HI), (ii) low-intensity RE at 20% of 1RM (LI) and (iii) low-intensity RE at 20% of 1RM combined with partial blood flow restriction (LI+BFR). HR, blood pressure, SpO2 and RPE were assessed. The data were analysed using repeated measures analysis of variance and the Wilcoxon test for RPE. The results indicated that all protocols significantly increased HR, both immediately postexercise and during the subsequent 60 min (P<0·05), and postexercise DP (P<0·05), but there were no differences between protocols. The protocols of LI and LI+BFR reduced postexercise SpO2 (P = 0·033, P = 0·007), and the LI+BFR protocol presented a perception of greater exertion in the lower limbs compared with HI (P = 0·022). We conclude that RE performed at low intensity combined with BFR seems to reduce the SpO2 after exercise and increase HR and DP while maintaining a perception of greater exertion on the lower limbs.

The aim of this study was to investigate the responses of creatine kinase (CK) and lactate dehydrogenase (LDH) after performing different resistance and aerobic exercise protocols. Twelve recreationally trained men (age, 23.2 ± 5.6 years; body mass, 84.3 ± 9.3 kg; body height, 178.9 ± 4.5 cm; and BMI, 26.3 ± 2.3 kg·m2) volunteered to participate in this study. All subjects were randomly assigned to four experimental protocols (crossover): (a) aerobic training at 60% of VO2max, (b) aerobic training at 80% of VO2max, (c) a resistance exercise (RE) session with a bi-set protocol, and (d) an RE session with a multiple sets protocol. Blood samples were collected before, immediately after and 24 hours following the experimental protocols. After 24 hours, there was a significant increase in CK for the 80% of VO2max protocol vs. the bi-set RE session (p = 0.016). Immediately after the protocols, we observed a significant increase in LDH among certain groups compared to others, as follows: multiple sets RE session vs. 60% of VO2max, bi-set RE session vs. 60% of VO2max, multiple sets RE session vs. 80% of VO2max, and bi-set RE session vs. 80% of VO2max (p = 0.008, p = 0.013; p = 0.002, p = 0.004, respectively). In conclusion, aerobic exercise performed at 80% of VO2max appears to elevate plasma CK levels more than bi-set RE sessions. However, the bi-set and multiple sets RE sessions appeared to trigger greater levels of blood LDH compared to aerobic protocols performed at 60% and 80% of VO2max.