Uniform Neuromuscular Responses Across Varied Blood Flow Restriction Training Strategies

Howard, MA, Rivera, PM, Lubiak, SM, Proppe, CE, Schmidt, JT, Rolnick, N, Shobe, ED, Fraifer, TL, and Hill, EC. Uniform neuromuscular responses across varied blood flow restriction training strategies. J Strength Cond Res 40(3): 304-310, 2026-The purpose of this investigation was to assess neuromuscular responses during acute bouts of resistance exercise with low-load blood flow restriction (LLBFR) performed with a 75-repetition protocol (75-rep; 1 × 30, 3 × 15), 3 sets to failure (3×), and 1 set to failure (1×). Seventeen recreationally active females randomly completed 75-rep, 3×, and 1× protocols consisting of unilateral, submaximal (30% of maximal voluntary isometric contraction), isokinetic (90°·s -1 ), leg extension muscle actions. A greater number of repetitions were performed during set 1 of the 1× protocol (59.5 ± 35.1) compared with the 75-rep protocol (30.0 ± 0.0), and more total repetitions were performed in the 3× protocol (85.2 ± 42.2) compared with the 1× protocol (59.5 ± 35.1). Surface electromyographic (sEMG) amplitude (AMP) progressively increased and then plateaued after 2 sets for the 75-rep protocol (118.3 ± 31.4% to 185.9 ± 85.3%; p = 0.043) and after 1 set of the 3× protocol (119.6 ± 8.6% to 206.3 ± 84.1%; p = 0.003). In addition, sEMG mean power frequency (MPF) decreased and then plateaued after 3 sets of the 75-rep protocol (99.8 ± 3.5% to 88.8 ± 11.7%; p = 0.012) and after 1 set of the 3× protocol (101.0 ± 8.2% to 84.4 ± 18.9%; p < 0.001). The changes in sEMG AMP and sEMG MPF across multiple sets (i.e., 75-rep and 3×) never exceeded the changes observed after the 1× protocol. Despite variations in set and repetition schemes, performing just 1 set of LLBFR to failure was sufficient to maximize acute neuromuscular responses. This highlights the efficiency of a single-set LLBFR protocol as a time-effective option for athletes and practitioners.