Heavy-load Resistance Training With and Without Blood Flow Restriction Therapy in Athletes

Effects of Heavy-load Resistance Training With and Without Blood Flow Restriction Therapy on Quadriceps Muscle Strength and Endurance in Athletes

A 8 weeks, single-blinded randomized controlled trial will be conducted at Pakistan Sports Board (PSB). Forty-four athletes (18-35 years) will be randomized into Group A (HL-RT + BFR, n = 22) and Group B (HL-RT only, n = 22). BFR will be applied at 50% limb occlusion pressure during lower-body exercises (squats, leg press). Both groups trained 3x/week for 4 weeks at 70-80% 1RM. Outcomes included 1RM strength, squat endurance, push-up performance, and International Physical Activity Questionnaire (IPAQ) scores.

This study is a single-blinded randomized controlled trial (RCT) comparing heavy-load resistance training (HLRT) with blood flow restriction (BFR) versus HLRT alone. Participants will be blinded to group allocation, but outcome assessors will not remain blinded throughout the study.

Group A participants will perform three important exercises namely back squats, leg press, and bench press. Those exercises were performed at a training intensity ranging from 70-80% of each person's 1-repetition maximum (1RM). 12 cm pneumatic cuffs was placed proximally on the thigh (for exercise of lower body) and arm (for exercise of upper body), and blood flow restriction was applied through them. Doppler ultrasound was used weekly to measure limb occlusion pressure (LOP) to then set the cuff pressure at 50% of each participant's predetermined LOP. During working sets it was made the cuffs inflated but during rest periods they were deflated. The exercise protocol consists of:

• Back squats: 4 sets of 6 repetitions
• Leg press: 3 sets of 8 repetitions
• Bench press: 3 sets of 10 repetitions All sets will be followed by a standardized 2-minute rest period. Training load will progressively increased by 2.5-5% when participants can complete all prescribed repetitions with proper form for two consecutive sessions.

Group B: Heavy-Load Resistance Training Only (HLRT) This control group will perform the identical exercise protocol (same exercises, intensities, volumes, and rest periods) as the BFR group, but without any blood flow restriction application. The same progression criteria will be used for both groups to ensure comparable training stimulus.

Post-Intervention Data Collection (Week 4)

Following the 4-week intervention period, all participants were undergone reassessment using the same measures collected at baseline:

1. 1RM testing for back squat and bench press
2. Muscular endurance tests (max repetition squat test and 1-minute push-up test)
3. International Physical Activity Questionnaire (IPAQ)

Inclusion Criteria:

• Participants with age between 18 and 35 years.
• Active individual participating in sport activities at least 3 times a week for the past 6 months.
• Participants with any non-heart conditions.
• Individuals voluntarily participating and providing informed consent.
• Sprinters, Footballer

Exclusion Criteria:

• Individuals with DVT or other pulmonary artery disease.
• Pregnant women or those planning to become pregnant.
• Participants with recent musculoskeletal injuries (within the 6 months).
• Individuals currently involved in another study.
• Participants allergic to or sensitive to the materials used in the BFR bands.
• Individuals who anticipate being unable to attend all training sessions.