Effects of Back Squat Exercise with or Without Blood Flow Restriction in Healthy Adolescent Basketball Athletes (BFR)

November 11, 2024 updated by: Perla Mjaess, St Joseph University, Beirut, Lebanon

Effects of Back Squat Exercise with or Without Blood Flow Restriction in Healthy Adolescent Basketball Athletes: a Randomized Controlled Trial

The goal of this clinical trial is to assess the effectiveness of Blood Flow Restriction (BFR) training compared to traditional high-intensity training in adolescent basketball players aged 16-18. The main questions it aims to answer are:

Does BFR training improve muscle strength more effectively than traditional high-intensity training? Does BFR training enhance jump height and ground reaction force (GRF) while reducing mechanical load? Researchers will compare BFR training to traditional high-intensity training to see if BFR training offers greater improvements in muscle strength, jump height, and GRF while potentially reducing knee joint stress.

Participants will:

Be randomly assigned to either the BFR training group or the high-intensity training group.

Undergo performance evaluations, including measurements of muscle strength, jump height, and GRF at three time points throughout the study.

Follow a training protocol specific to their assigned group

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Detailed Description:

This randomized controlled study aims to evaluate the effectiveness of Blood Flow Restriction (BFR) training compared to traditional high-intensity training in adolescent basketball players, focusing on performance enhancement and safety. The study was approved by the Committee Research Ethics of Saint Joseph University of Beirut (Code: 2023-325) on December 7, 2023.

Study Setting and Participants: The research was conducted within two sports academies in Lebanon, Mont La Salle and Rebound academies. A total of 50 adolescent basketball players, aged 16-18 years, participated. Inclusion criteria required regular training (at least three sessions per week) and competitive basketball experience within the last six months. Exclusion criteria included history or presence of cardiovascular, pulmonary, or metabolic conditions, vascular disorders, coagulation disorders, or ongoing anticoagulant therapy. Before starting the study, participants completed a recruitment questionnaire to gather demographic data and assess eligibility for BFR training.

Study Design and Randomization: Participants were randomly assigned into two groups:

Group 1 (BFR Training Group): Engaged in low-intensity resistance training (20-30% of 1RM) with BFR using pressure cuffs on the lower limbs.

Group 2 (High-Intensity Training Group): Engaged in traditional high-intensity resistance training (65-80% of 1RM) without BFR.

Both groups completed 12 sessions over six weeks, with a 48-hour interval between sessions. The study's structured approach allows for a comparison of the training modalities' effects on muscle strength, jump height, and ground reaction force (GRF).

Evaluation Protocol: Participants underwent baseline assessments before starting the exercise regimen. These assessments included occlusion pressure, 1-repetition maximum (1RM) testing, muscle strength, jump height, and GRF.

Occlusion Pressure Measurement: Measured using the VALD-performance system (Version 3 of the Airbands model, Australia) with athletes seated and cuffs placed proximally on the thigh (25% of the femur length).

1RM Testing: Participants performed warm-up sets before progressively increasing load until reaching the maximum weight they could lift with proper form.

Muscle Strength: Assessed using a digital dynamometer (KINVENT, K-PULL, France) for both quadriceps and hamstring muscles.

Jump Height and GRF: Evaluated using a force platform (KINVENT, France) during counter-movement jumps (CMJs).

Evaluations were conducted at three time points: baseline (M1), mid-intervention at three weeks (M2), and post-intervention at six weeks (M3). Each measurement was performed three times to ensure inter-rater reliability, with four physiotherapists maintaining consistency by evaluating the same athletes throughout the study.

Intervention Protocols:

Group 1 (BFR Training Group): Performed four sets of back squats at 20% of 1RM during weeks 1-3, increasing to 25% at week 3, and 30% during weeks 5-6.

Group 2 (High-Intensity Training Group): Began with 65% of 1RM in weeks 1-3, increasing to 70% at week 3, and 80% during weeks 5-6.

Both protocols aimed to progressively enhance strength while monitoring the effects on joint stress and overall performance.

Outcome Measures: The primary outcomes included changes in quadriceps and hamstring strength, jump height, and GRF over the intervention period. Secondary outcomes assessed knee joint stress and participant satisfaction with their respective training protocols.

Statistical Analysis: Data were analyzed using XLStat® software (AddinsoftR, Paris, France; version 2019.1.2). Descriptive statistics were calculated for demographic data. Mann-Whitney U tests were used for comparing groups, while Wilcoxon signed-rank tests evaluated within-group differences across time points (ΔM2-M1, ΔM3-M2, and ΔM3-M1). The reliability of measurements was assessed using the Intraclass Correlation Coefficient (ICC).

The study results are expected to provide insights into the effectiveness of BFR as a safer, low-load alternative to traditional high-intensity training in adolescent athletes, potentially offering a means to optimize performance while minimizing injury risk.

Study Type

Interventional

Enrollment (Actual)

39

Phase

  • 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

  • Lebanon
      • Beirut, Lebanon
        • Two sports academies in Lebanon (Mont la salle and Rebound academies)

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

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Aged between 16 and 18 years.
  • Engaged in basketball training sessions at least three times per week.
  • Competed in basketball within the last six months.
  • No major injuries that limit their training session routines.

Exclusion Criteria:

  • History or presence of cardiac, pulmonary, or metabolic conditions.
  • Presence of vascular disorders in the upper or lower limbs.
  • Individuals with coagulation disorders or those undergoing anticoagulant therapy.
  • Recent surgeries or chronic conditions contraindicating Blood Flow Restriction (BFR) training.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Back Squat Exercise without Blood Flow Restriction
In this arm of the study, participants will perform back squat exercises without any blood flow restriction. This group serves as a control to evaluate the effects of traditional resistance training alone on strength and muscle development in healthy adolescent basketball athletes.
Behavioral: Back squats
Back squats without any blood flow restriction
Experimental: Back Squat Exercise with Blood Flow Restriction
This arm of the study involves participants performing back squat exercises while blood flow restriction is applied to the upper legs. The aim is to assess the effects of combining traditional resistance training with blood flow restriction on strength and muscle hypertrophy in healthy adolescent basketball athletes.
Device: Back squat with Blood flow restriction machine
The blood flow restriction (BFR) machine is a specialized device designed to safely apply controlled pressure to the proximal limbs during exercise. It typically consists of adjustable cuffs or bands that are placed around the upper arms or thighs, which are connected to a pressure monitoring system. The device enables practitioners to restrict venous blood flow while allowing arterial blood flow to the working muscles. This method enhances the effects of low-intensity resistance training by promoting muscle hypertrophy and strength gains, similar to those achieved through high-intensity training. The BFR machine is commonly used in rehabilitation settings and athletic training programs to optimize performance and recovery while minimizing the risk of injury.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quadriceps Muscle strength (Kg)
Time Frame: Baseline (Day 0, before starting the protocol), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Assessed using a digital dynamometer, this measure reflects the improvement in quadriceps strength, a key indicator of the effectiveness of low-intensity training with BFR.
Baseline (Day 0, before starting the protocol), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Hamstring Muscle Strength (kg)
Time Frame: Baseline (Day 0, before starting the protocol), 3 weeks after the baseline assessment (Day 21), and 48 hours after the last session, approximately 6 weeks after the baseline assessment (Day 42).
Evaluates the hamstring strength using a digital dynamometer to provide a broader view of muscle strength changes.
Baseline (Day 0, before starting the protocol), 3 weeks after the baseline assessment (Day 21), and 48 hours after the last session, approximately 6 weeks after the baseline assessment (Day 42).
Jump Height (cm)
Time Frame: Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Measures maximum jump height using a force platform to assess changes in lower limb explosive power.
Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Ground reaction force (Newton)
Time Frame: Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Assesses the peak force generated during the landing phase of a countermovement jump using a force platform.
Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
1RM (One Repetition Maximum) (kg)
Time Frame: Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Evaluates the maximum weight that an athlete can lift in a single squat repetition.
Baseline (Day 0), 3 weeks after baseline (Day 21), and 48 hours after the last session, approximately 6 weeks after baseline (Day 42).
Occlusion Pressure (mmHg)
Time Frame: Pre-exercise on Day 0 (Baseline).
Measures the pressure applied during the BFR sessions, recorded using an automated system.
Pre-exercise on Day 0 (Baseline).
Inter-Rater Reliability (ICC)
Time Frame: Throughout the duration of the study (up to 6 weeks).
Evaluates the reliability of the measurements performed by different physiotherapists using the Intraclass Correlation Coefficient (ICC).
Throughout the duration of the study (up to 6 weeks).

Collaborators and Investigators

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

Sponsor

St Joseph University, Beirut, Lebanon

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)

January 1, 2024

Primary Completion (Actual)

April 1, 2024

Study Completion (Actual)

June 1, 2024

Study Registration Dates

First Submitted

October 17, 2024

First Submitted That Met QC Criteria

November 11, 2024

First Posted (Estimated)

November 12, 2024

Study Record Updates

Last Update Posted (Estimated)

November 12, 2024

Last Update Submitted That Met QC Criteria

November 11, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 2023-325

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

In this study, the investigators plan to share the following specific individual participant data (IPD) upon completion of the trial:

Demographic Information:

Participants' age, gender, and baseline characteristics such as height, weight, and basketball experience.

Intervention Details:

Information regarding which intervention each participant received, specifically whether they performed back squat exercises with blood flow restriction or standard back squat exercises without restriction.

Outcome Measures:

Results for primary and secondary outcome measures, including:

Muscle strength (1-repetition maximum testing results). Muscle hypertrophy (cross-sectional area measurements via ultrasound). Jump height Ground reaction force

Adverse Events:

Any recorded adverse events or side effects related to the interventions during the study period.

Study Protocol Data:

A summary of the study protocol, including the randomization process, assessment methods, and data collection procedures.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

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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