Blood flow restricted and traditional resistance training performed to fatigue produce equal muscle hypertrophy

This study investigated the hypertrophic potential of load-matched blood-flow restricted resistance training (BFR) vs free-flow traditional resistance training (low-load TRT) performed to fatigue. Ten healthy young subjects performed unilateral BFR and contralateral low-load TRT elbow flexor dumbbell curl with 40% of one repetition maximum until volitional concentric failure 3 days per week for 6 weeks. Prior to and at 3 (post-3) and 10 (post-10) days post-training, magnetic resonance imaging (MRI) was used to estimate elbow flexor muscle volume and muscle water content accumulation through training. Acute changes in muscle thickness following an early vs a late exercise bout were measured with ultrasound to determine muscle swelling during the immediate 0-48h post-exercise. Total work was threefold lower for BFR compared with low-load TRT (P<0.001). Both BRF and low-load TRT increased muscle volume by approximately 12% at post-3 and post-10 (P<0.01) with no changes in MRI-determined water content. Training increased muscle thickness during the immediate 48h post-exercise (P<0.001) and to greater extent with BRF (P<0.05) in the early training phase. In conclusion, BFR and low-load TRT, when performed to fatigue, produce equal muscle hypertrophy, which may partly rely on transient exercise-induced increases in muscle water content.