Post-Activation Performance Enhancement in Single and Multi-Joint Exercises with BFR and EMS in Male Volleyball Players (PAPE-BFR-EMS)

March 7, 2025 updated by: Neslihan AKÇAY, Karabuk University

Post-activation Performance Enhancement in Multi- Vs Single-Joint Movements: a Comparative Study of BFR and EMS in Male Volleyball Athletes

Investigators used a randomized controlled crossover design to compare the effect of blood flow restriction (BFR) and electrical muscle stimulation (EMS) protocols on post-activation performance enhancement (PAPE) in multi-joint versus single-joint exercises. Participants took part in six test sessions 72 hours apart. In the BFR group, 50% of the arterial occlusion pressure (AOP) was used. In the EMS group, a 75 Hz current was applied. In the Low Resistance exercise group, only exercise was performed without any condition. Bench press (multi-joint) and triceps push-down (single-joint) exercises were used in the conditions.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Active, not recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Participants took part in six test sessions 72 hours apart. All tests were performed between 2 and 4 pm to reduce the influence of circadian rhythms or fatigue on performance. Anthropometric measurements, 1 RM test, and grip strength and serving speed tests were determined before the practice session on the first day as a control condition. On the other six experimental days, players were randomly assigned to protocols (BFR, EMS, and LOW-LOAD) using software (http://www.randomizer.org). In the BFR group, 50% of the arterial occlusion pressure (AOP) was used. In the EMS group, a 75 Hz current was applied. In the Low Resistance exercise group, only exercise was performed without any condition. Bench press (multi-joint) and triceps push-down (single-joint) exercises were used in the conditions. In all protocols, participants performed a standardized warm-up protocol consisting of a 5-minute run at 9 km/h on a treadmill and a general warm-up consisting of 3 minutes of whole-body light stretching exercises. Following the warm-up and pre-exercise protocols, grip strength and service speed tests were performed with rest periods.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
15

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Karabük, Turkey, 78200
        • Karabuk University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being healthy
  • Male volleyball athletes
  • Willing to maintain the intervention for all sessions

Exclusion Criteria:

  • Being under 18 years old
  • Having a chronic disease
  • Contraindication for Electromyostimulation (EMS)
  • Contraindication for Blood Flow Restriction (BFR)
  • Contraindications for exercise

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Crossover Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Active Comparator: Blood flow restriction
In the BFR group, 50% of the arterial occlusion pressure (AOP) was used.Bench press (multi-joint) and triceps push-down (single-joint) exercises were used in the conditions.
Other: Blood Flow Restriction
The arterial occlusion pressures (AOP) of the athletes randomized to the experimental group will be obtained automatically with the digital LED display CAC device BFR Unit (Fit Cuffs BFR Unit, Denmark). The AOP pressure device BFR Unit (Fit Cuffs BFR Unit, Denmark) will be used to apply 50% occlusion pressure during exercise. Bench press and triceps push down exercises will be performed with 30% 1TM, 30-15-15-15 repetitions and thirty seconds rest between sets.
Other Names:
  • BFR
Active Comparator: Electrical muscle stimulation
In the EMS group, a 75 Hz current was applied. Bench press (multi-joint) and triceps push-down (single-joint) exercises were used in the conditions.
Other: Electrical Muscle Stimulation
EMS will be applied bilaterally to the wrist flexor and elbow extensor muscles using a portable EMS stimulator (Compex Rehab 400, Medicompex SA, Ecublens, Switzerland). Four 2 mm thick, self-adhesive electrodes (5x5 cm) will be placed on the superficial aspect of each muscle group. The athletes will simultaneously receive EMS intervention with a pulse frequency of 75 Hz and a duration of 400 μs (19 seconds rest between pulses) during bench press and triceps pushdown exercises. Bench press and triceps push down exercises will be performed with 30% 1TM, 30-15-15-15 repetitions and thirty seconds rest between sets.
Other Names:
  • EMS
Active Comparator: Low Load Resistance Exercise
In the Low Resistance Exercise group, only exercise was performed without any condition (BFR or EMS. Bench press (multi-joint) and triceps push-down (single-joint) exercises were used in the conditions.
Other: Low-Load Resistance Exercise
Bench press and triceps pushdown exercises will be performed with 30% 1RM, 30-15-15-15 repetitions and 30 seconds rest between sets.
Other Names:
  • LL-RE

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Service speed
Time Frame: From baseline to the end of treatment at 8 weeks
Service speed will assess by standard radar apparatus (Net Playz Smart Pro Speed Radar, USA) and will record in km/h.
From baseline to the end of treatment at 8 weeks
Hand Grip strength
Time Frame: From baseline to the end of treatment at 8 weeks
Hand grip strength will assess by hand grip dynamometer (Takei 5,101, Tokyo, Japan) and will record in kg.
From baseline to the end of treatment at 8 weeks

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Anthropometric Measurements 1
Time Frame: Baseline
Participants' height (cm) will assess by using a stadiometer (Holtain Stadiometer, England).
Baseline
Anthropometric Measurements 3
Time Frame: Baseline
Body mass index (BMI) (kg/m2) will asses by Inbody 270 (Biospace, California, USA).
Baseline
Anthropometric Measurements 2
Time Frame: Baseline
Body weight (kg) will asses by Inbody 270 (Biospace, California, USA).
Baseline
Bench Press 1Repetition maximum Test
Time Frame: Baseline
The 1RM values of the participants will assess by using a bench press machine.
Baseline
Triceps Push Down 1 repetition maximum Test
Time Frame: Baseline
The participants will instruct to assume a standing position in front of the triceps push-down machine, holding the bar with both hands in the pronated position at shoulder width. During the execution of this exercise, the participants will maintain their arms near their torso, ensuring that there was no contact between the arms and the body.
Baseline
Anthropometric Measurements 4
Time Frame: Baseline

Body fat percentage (%) will asses by Inbody 270 (Biospace, California, USA).

Baseline
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Karabuk University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Neslihan Akçay, Doctorate, Karabuk University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 10, 2025

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
August 9, 2025

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
October 29, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 25, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 7, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 25, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 25, 2025

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 7, 2025

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
March 1, 2025

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • UKarabuk-2

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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