Impact of blood flow restriction cuff design on upper body exercise: A randomized crossover trial in resistance-trained adults

Differences in cuff blood flow restriction (BFR) bladder design (single-chambered [SC-BFR] and multi-chambered [MC-BFR] systems) may influence exercise performance, perceptual responses, and cardiovascular outcomes. In a randomized cross-over design, twenty-six healthy physically active individuals (22.6 ± 5.5 years old, 10 females; 25 reported engaging in resistance-exercise consistently) performed four sets of bilateral biceps curls to volitional failure using 20% of the 1-repetition maximum under three conditions: SC-BFR, MC-BFR, and a non-BFR control, post-exercise perceptual responses, and cardiovascular measures pre- and post-exercise. SC-BFR significantly reduced total repetitions compared to MC-BFR and N-BFR (p < 0.001). MC-BFR and N-BFR conditions demonstrated comparable performance in later sets. RPD was significantly higher in SC-BFR compared to MC-BFR and N-BFR (p < 0.001), while MC-BFR elicited lower RPE than SC-BFR (p = 0.025). Both SC-BFR and N-BFR conditions significantly reduced post-exercise diastolic blood pressure and mean arterial pressure, whereas MC-BFR did not. No significant differences in PWV were observed across conditions. SC-BFR induces greater repetition reduction and perceptual discomfort than MC-BFR, while MC-BFR demonstrates similar performances and comfort to N-BFR in later sets. Findings suggest cuff design plays a role in acute BFR responses.