Blood-Flow Restriction Resistance Exercise Promotes Lower Pain and Ratings of Perceived Exertion Compared With Either High- or Low-Intensity Resistance Exercise Performed to Muscular Failure

in Journal of Sport Rehabilitation
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Context: Given the comparable muscle hypertrophy constantly observed between blood-flow restriction exercise (BFR-RE) and conventional resistance exercise, understanding their particular rating of perceived exertion (RPE) and pain may help to better prescribe exercise at a low-discomfort level, thus increasing its feasibility. Design: Randomized crossover study. Objective: To compare the RPE and pain response between conventional high- (HI-RE) and low-intensity resistance exercise (LI-RE) protocols to failure with a nonmuscular failure LI-RE associated with BFR-RE. Participants: A total of 12 men (age: 20 [3] y; body mass: 73.5 [9] kg; height: 174 [6] cm). Interventions: Four sets of 45° leg-press exercises in 3 different conditions: (1) BFR-RE (15 repetitions; 30% 1-repetition maximum), (2) HI-RE (80% 1-repetition maximum to muscular failure), and (3) LI-RE (30% 1-repetition maximum to muscular failure). Main Outcome Measures: RPE and pain were assessed immediately before exercise session and after the end of each of the 4 sets. Results: RPE and pain levels increased throughout the exercise sets for all RE protocols (all, Ps < .05). HI-RE and LI-RE protocols showed similar increase in RPE and pain levels during all exercise sets (P < .05); however, both protocols demonstrated higher RPE and pain response compared with BFR-RE after each of the 4 sets (all Ps < .05 between-group comparisons). Conclusions: Our results demonstrated that both HI-RE and LI-RE to muscular failure resulted in similar and significant increases in RPE and pain levels, regardless of exercise intensity. In addition, nonmuscular failure BFR-RE also increased RPE and pain response, however, to a lower extent compared with either HI-RE or LI-RE.

Lixandrão, Roschel, and Ugrinowitsch are with the School of Physical Education and Sport, University of São Paulo (USP), São Paulo, Brazil. Miquelini, Alvarez, and Libardi are with the MUSCULAB – Laboratory of Neuromuscular Adaptations to Resistance Training, Department of Physical Education, Federal University of São Carlos – UFSCar, São Carlos, Brazil.

Libardi (c.libardi@ufscar.br) is corresponding author.
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