Electromyographic Response to Blood Flow Restriction Exercise in Healthy Adults

July 23, 2026 updated by: Carlos Fernández-Morales, Universidad de Extremadura

Electromyographic Analysis of Immediate Neuromuscular Response After Low-Load Knee Extension Exercise With and Without Blood Flow Restriction in Healthy Adults

This pilot randomized contralateral within-participant study evaluated the immediate neuromuscular response to low-load knee extension exercise performed with and without blood flow restriction in healthy young adults.

Participants were randomized in a 1:1 ratio to one of two limb-allocation groups: blood flow restriction applied to the dominant limb or blood flow restriction applied to the non-dominant limb. In each participant, the contralateral limb completed the same exercise protocol without blood flow restriction. Therefore, all participants were assessed under both experimental conditions.

Both limb-specific conditions were completed during the same experimental session. The order of the blood flow restriction and non-blood flow restriction conditions was randomized for each participant, with a 10-minute rest period between conditions.

Blood flow restriction was applied using a pneumatic cuff positioned on the proximal thigh. Cuff pressure was individualized and set at 80% of the arterial occlusion pressure measured for the corresponding limb. Participants completed the same standardized low-load knee extension protocol under both conditions.

Surface electromyography was used to record vastus lateralis activity from each assessed limb during the exercise protocol. Muscle activity was primarily evaluated using root mean square amplitude normalized to the pre-exercise maximal voluntary isometric contraction recorded from the corresponding limb. Root mean square amplitude during maximal voluntary isometric contraction trials was also recorded before and immediately after each condition.

The study aimed to compare the electromyographic response between the blood flow restriction and non-blood flow restriction conditions and to determine whether this response differed according to whether blood flow restriction was applied to the dominant or non-dominant limb.

Study Overview

Study Type

Interventional

Enrollment (Actual)

24

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

    • Badajoz
      • Badajoz, Badajoz, Spain, 06006
        • University of Extremadura

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age between 18 and 65 years.
  • Healthy adults.
  • Absence of active pain or musculoskeletal injury in the lower limbs at the time of assessment.
  • Ability to understand the study procedures.
  • Voluntary agreement to participate and provision of written informed consent.

Exclusion Criteria:

  • History of neuromuscular disease.
  • History of cardiovascular disease.
  • History of peripheral vascular disease.
  • History of thromboembolic events.
  • Uncontrolled hypertension.
  • Skin lesions or skin conditions preventing placement of the blood flow restriction cuff or surface electromyography electrodes.
  • Recent lower limb surgery.
  • Pregnancy.
  • Any other contraindication to blood flow restriction 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: Basic Science
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental: BFR allocated to the dominant limb
Participants received blood flow restriction on the dominant limb, while the contralateral non-dominant limb completed the same low-load knee extension protocol without blood flow restriction. Both limb-specific conditions were performed during the same experimental session in randomized order, with a 10-minute rest period between conditions. Blood flow restriction pressure was individualized and set at 80% of the arterial occlusion pressure of the corresponding limb. Vastus lateralis surface electromyography was recorded under both conditions.
Each participant completed the low-load knee extension exercise protocol separately with both lower limbs. Under each condition, the protocol comprised 75 repetitions distributed across four sets of 30, 15, 15, and 15 repetitions, with 30 seconds of rest between sets. One limb performed the protocol with blood flow restriction and the contralateral limb performed it without blood flow restriction. Condition order was randomized, and a 10-minute rest period was provided between the two limb-specific conditions. Vastus lateralis surface electromyography was recorded continuously during each protocol.
A pneumatic cuff was placed on the proximal thigh of the limb randomized to the blood flow restriction condition and inflated to 80% of the individualized arterial occlusion pressure during the low-load knee extension protocol. The cuff was not applied to the contralateral limb, which completed the same protocol under the non-blood flow restriction condition. The cuff was fully deflated and removed after completion of the blood flow restriction condition.
Experimental: Experimental: BFR allocated to the non-dominant limb
Participants received blood flow restriction on the non-dominant limb, while the contralateral dominant limb completed the same low-load knee extension protocol without blood flow restriction. Both limb-specific conditions were performed during the same experimental session in randomized order, with a 10-minute rest period between conditions. Blood flow restriction pressure was individualized and set at 80% of the arterial occlusion pressure of the corresponding limb. Vastus lateralis surface electromyography was recorded under both conditions.
Each participant completed the low-load knee extension exercise protocol separately with both lower limbs. Under each condition, the protocol comprised 75 repetitions distributed across four sets of 30, 15, 15, and 15 repetitions, with 30 seconds of rest between sets. One limb performed the protocol with blood flow restriction and the contralateral limb performed it without blood flow restriction. Condition order was randomized, and a 10-minute rest period was provided between the two limb-specific conditions. Vastus lateralis surface electromyography was recorded continuously during each protocol.
A pneumatic cuff was placed on the proximal thigh of the limb randomized to the blood flow restriction condition and inflated to 80% of the individualized arterial occlusion pressure during the low-load knee extension protocol. The cuff was not applied to the contralateral limb, which completed the same protocol under the non-blood flow restriction condition. The cuff was fully deflated and removed after completion of the blood flow restriction condition.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Vastus Lateralis Electromyographic Amplitude Normalized to Maximal Voluntary Isometric Contraction
Time Frame: During the exercise protocol, within a single experimental session.
Surface electromyographic activity of the vastus lateralis was assessed during the low-load knee extension exercise protocol. The root mean square amplitude was normalized to the maximal voluntary isometric contraction recorded before exercise and expressed as percentage of maximal voluntary isometric contraction (%MVIC). Measurements were extracted at predefined time points across the four exercise sets in both experimental conditions.
During the exercise protocol, within a single experimental session.

Collaborators and Investigators

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

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)

March 3, 2026

Primary Completion (Actual)

April 15, 2026

Study Completion (Actual)

April 15, 2026

Study Registration Dates

First Submitted

June 12, 2026

First Submitted That Met QC Criteria

June 12, 2026

First Posted (Actual)

June 17, 2026

Study Record Updates

Last Update Posted (Actual)

July 27, 2026

Last Update Submitted That Met QC Criteria

July 23, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 13

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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