Combining Resting Blood Flow Restriction with Neuromuscular Electrical Stimulation: Effects on Blood Lactate Levels and Lower Limb Muscle Function

The current research landscape shows studies indicating increased muscle strength and hypertrophy through neuromuscular electrical stimulation combined with blood flow restriction. However, there is a lack of research specifically on the effects of this combination during rest periods. Therefore, the primary objective of this study is to investigate the impact of resting blood flow restriction training combined with neuromuscular electrical stimulation on blood lactate levels and changes in lower limb muscle function in healthy male adults.

Study Overview

• Status: Completed
• Conditions: Healthy
• Intervention / Treatment: Device: Blood Flow Restriction; Device: Neuromuscular Electrical Stimulation; Behavioral: Squat exercise

• Study Type: Interventional
• Enrollment (Actual): 12
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Gwangju, Korea, Republic of, 62399
    • Honam University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Healthy adult males in their 20s,
• Individuals who answered less than one item on the PAR-Q (Physical Activity Readiness Questionnaire),
• Participants who consented to the use and publication of their physical function evaluation data and expressed a desire to participate in the exercise experiment.

Exclusion Criteria:

• Individuals with severe hypertension (blood pressure above 170/110 mmHg),
• Individuals with a history of deep venous thrombosis,
• Individuals with endothelial dysfunction,
• Individuals with peripheral vascular disease,
• Individuals with one or more of the following conditions: diabetes, infection, cancer,
• Participants who expressed a desire to withdraw during the study period or whose participation rate was below 80% were excluded from the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Single Group Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: rest-Blood Flow Restriction plus Neuromuscular Electrical Stimulation	Device: Blood Flow Restriction; The study participants were instructed to rest quietly in a seated position for 10 minutes. During the last 3 minutes of the resting period, upper arm blood pressure was measured twice using an automatic blood pressure monitor (BP170, InBody, Korea). The blood flow restriction cuffs (BFR Therapy Cuff, BFR Therapy Co., USA) - measuring 5cm in width and 60cm in length - were applied to the upper third of the thigh on both legs. To maintain consistency in measurements, the distance from the proximal part of the kneecap to the distal edge of the cuff was measured. A Capillary Reaction Time (CRT) test was used to assess the appropriateness of the cuff pressure; this involved applying thumb pressure to the quadriceps muscle after cuff application and timing how long it took for the skin color to return to normal.; Device: Neuromuscular Electrical Stimulation; Neuromuscular Electrical Stimulation (NMES) was applied five times a week for one week using a four-channel stimulator (Compex Physio, Chattanooga, Switzerland). The stimulation protocol was set to a frequency of 35Hz, with electrodes attached to the vastus lateralis and vastus medialis muscles. The therapist adjusted the intensity and alternating output of the electrodes selectively to facilitate the squat exercises required during the intervention. During the stimulation period, participants were engaged in a squat exercise program, with the total duration of stimulation being 10 minutes.
Active Comparator: rest-Blood Flow Restriction	Device: Blood Flow Restriction; The study participants were instructed to rest quietly in a seated position for 10 minutes. During the last 3 minutes of the resting period, upper arm blood pressure was measured twice using an automatic blood pressure monitor (BP170, InBody, Korea). The blood flow restriction cuffs (BFR Therapy Cuff, BFR Therapy Co., USA) - measuring 5cm in width and 60cm in length - were applied to the upper third of the thigh on both legs. To maintain consistency in measurements, the distance from the proximal part of the kneecap to the distal edge of the cuff was measured. A Capillary Reaction Time (CRT) test was used to assess the appropriateness of the cuff pressure; this involved applying thumb pressure to the quadriceps muscle after cuff application and timing how long it took for the skin color to return to normal.
Active Comparator: Squat Exercise	Behavioral: Squat exercise; In this study, the squat exercise was performed in four sets. Participants were instructed to position their feet shoulder-width apart and educated to squat in such a way that their knees did not extend beyond their toes. To ensure consistency in performing the squat at the same angle, a mark was made on the wall at the pelvic height during a 90° squat. This allowed participants to perform squats at the same height. The exercise was conducted under the guidance of a physical therapist with five years of clinical experience.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Blood lactate	Lactate levels were measured using the Accutrend Plus (Roche, Germany). A small amount of whole blood was collected from the participants for blood lactate concentration analysis. The procedure involved the finger-prick method, where the tip of the right index finger was disinfected with an alcohol swab. Then, a lancet prepared for this purpose was used to obtain a small sample of capillary blood from the disinfected area. The collected blood was then applied to lactate strips, and the blood lactate analyzer (Accutrend Plus, Roche, Germany) provided the lactate level readings within 60 seconds.	Immediate change from baseline after intervention

Collaborators and Investigators

• Sponsor: Hyunjoong Kim

Study record dates

Study Major Dates

• Study Start (Actual): December 30, 2023
• Primary Completion (Actual): January 11, 2024
• Study Completion (Actual): January 30, 2024

Study Registration Dates

• First Submitted: December 23, 2023
• First Submitted That Met QC Criteria: December 23, 2023
• First Posted (Actual): January 9, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 20, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 1041223-202309-HR-30

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

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