The addition of blood flow restriction during resistance exercise does not increase prolonged low-frequency force depression.

At a given exercise intensity, blood flow restriction (BFR) reduces the volume of exercise required to impair post-exercise neuromuscular function. Compared to traditional exercise, the time course of recovery is less clear. After strenuous exercise, force output assessed with electrical muscle stimulation is impaired to a greater extent at low versus high stimulation frequencies, a condition known as prolonged low-frequency force depression (PLFFD). It is unclear if BFR increases PLFFD after exercise. This study tested if BFR during exercise increases PLFFD and slows recovery of neuromuscular function compared to regular exercise. Fifteen physically active participants performed six low-load sets of knee-extensions across four conditions: resistance exercise to task failure (RE), resistance exercise to task failure with BFR applied continuously (BFR) or intermittently (BFR), and resistance exercise matched to the lowest exercise volume condition (RE). Maximal voluntary contraction (MVC) force output, voluntary activation and a force-frequency (1-100 Hz) curve were measured before and 0, 1, 2, 3, 4 and 24 h after exercise. Exercise to task failure caused similar reductions at 0 h for voluntary activation (RE= 81.0 ± 14.2%, BFR= 80.9 ± 12.4% and BFR= 78.6 ± 10.7%) and MVC force output (RE= 482 ± 168 N, BFR= 432 ± 174 N, and BFR= 443 ± 196 N), which recovered to baseline values between 4 and 24 h. PLFFD occurred only after RE at 1 h supported by a higher frequency to evoke 50% of the force production at 100 Hz (1 h: 17.5 ± 4.4 vs. baseline: 15 ± 4.1 Hz, P = 0.0023), BFR (15.5 ± 4.0 Hz; P = 0.03), and RE (14.9 ± 3.1 Hz; P = 0.002), with a trend versus BFR (15.7 ± 3.5 Hz; P = 0.063). These findings indicate that, in physically active individuals, using BFR during exercise does not impair the recovery of neuromuscular function by 24 h post-exercise.