Physiology & Behavior 171 (2017) 181186

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Physiology & Behavior

journal homepage: www.elsevier.com/locate/phb

The effects of upper body exercise across different levels of blood flow
restriction on arterial occlusion pressure and perceptual responses
Kevin T. Mattocks, Matthew B. Jessee, Brittany R. Counts, Samuel L. Buckner, J. Grant Mouser, Scott J. Dankel,
Gilberto C. Laurentino, Jeremy P. Loenneke
Department of Health, Exercise Science, and Recreation Management. Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, MS, United States

H I G H L I G H T S

Higher relative pressures result in the greatest cardiovascular responses.

Perceptual responses are augmented with increasing applied pressure.
Due to the cardiovascular response, the relative restriction pressure decreases during exercise.

a r t i c l e i n f o a b s t r a c t

Article history: Recent studies have investigated relative pressures that are applied during blood ow restriction exercise ranging
Received 16 September 2016 from 40%90% of resting arterial occlusion pressure; however, no studies have investigated relative pressures
Received in revised form 28 October 2016 below 40% arterial occlusion pressure. The purpose of this study was to characterize the cardiovascular and per-
Accepted 9 January 2017
ceptual responses to different levels of pressures. Twenty-six resistance trained participants performed four sets
Available online 11 January 2017
of unilateral elbow exion exercise using 30% of their 1RM in combination with blood ow restriction inated to
one of six relative applied pressures (0%, 10%, 20%, 30%, 50%, 90% arterial occlusion pressure). Arterial occlusion
pressure was measured before (pre) and immediately after the last set of exercise at the radial artery. RPE and
discomfort were taken prior to (pre) and following each set of exercise. Data presented as mean (95% CI) except
for perceptual responses represented as the median (25th, 75th percentile). Arterial occlusion pressure increased
from pre to post (p b 0.001) in all conditions but was augmented further with higher pressures [e.g. 0%: 36 (30
42) mm Hg vs. 10%: 39 (3444) mm Hg vs. 90% 46 (4152) mm Hg]. For RPE and discomfort, there were signif-
icant differences across conditions for all sets of exercise (p b 0.01) with the ratings of RPE [e.g. 0%: 14.5 (13, 17)
vs. 10%: 13.5 (12, 17) vs. 90%: 17 (14.75, 19) during last set] and discomfort [e.g. 0%: 3.5 (1.5, 6.25) vs. 10%: 3 (1,
6) vs. 90%: 7 (4.5, 9) during last set] generally being greater at the higher restriction pressures. All of these differ-
ences at the higher restriction pressures occurred despite completing a lower total volume of exercise. Applying
higher relative pressures results in the greatest cardiovascular response, higher perceptual ratings, and greater
decrease in exercise volume compared to lower restriction pressures. Therefore, the perceptual responses from
lower relative pressures may be more appealing and provide a safer and more tolerable stimulus for individuals.
2017 Elsevier Inc. All rights reserved.

1. Introduction pressure (130% brachial systolic blood pressure) to applying an arbi-

Blood ow restriction training has been shown to increase muscle
size and strength similar to high-load resistance training [1,2] with
loads as low as 20% of the one repetition maximum (1RM). Throughout
the blood ow restriction literature, a variety of pressures have been ap-
plied ranging from relative pressures that are based on brachial systolic
Corresponding author at: Kevser Ermin Applied Physiology Laboratory, Department of
Health, Exercise Science, and Recreation Management, The University of Mississippi, 231
Turner Center, MS 38677, United States.
E-mail address: jploenne@olemiss.edu (J.P. Loenneke).
trary pressure to all individuals [3]. This may be a concern because ap-
plying an arbitrary pressure may restrict blood ow to a greater
extent than what was intended, leading to an exaggerated cardiovascu-
lar response [4]. Therefore, it is suggested that when applying pressure
to the cuff, the pressure should account for the individual's limb circum-
ference and width of the cuff [57]. One method to do this is to apply a
percentage of the resting arterial occlusion pressure which ensures that
all participants will receive a similar stimulus and may also reduce the
risk of a negative cardiovascular event [4,8].
Recent studies have investigated relative pressures ranging from
40%90% of resting arterial occlusion pressure during blood ow

http://dx.doi.org/10.1016/j.physbeh.2017.01.015
0031-9384/ 2017 Elsevier Inc. All rights reserved.
182 K.T. Mattocks et al. / Physiology & Behavior 171 (2017) 181186
restriction exercise [911]. However, there seems to be little augmenta-
tion in muscle adaptation beyond a relative pressure of 40% arterial oc-
clusion pressure [9]. To our knowledge, no studies have investigated
relative pressures below 40% arterial occlusion pressure during blood
ow restriction exercise. We hypothesize that there is likely a point at
which the relative pressure is too low to be efcacious. It is conceivable
that a pressure of 20% arterial occlusion may be high enough at rest but
during exercise drops outside of the hypothetical pressure range need-
ed for muscle adaptation due to the elevated cardiovascular response
[12,13]. Thus, the purpose of this study was to characterize the cardio-
vascular response to pressures below 40% arterial occlusion pressure
(0%, 10%, 20%, 30% arterial occlusion) and compare them to a moderate
(50% arterial occlusion pressure) and higher (90% arterial occlusion
pressure) relative pressure. We also sought to investigate the perceptu-
al response across these pressures to determine whether or not they dif-
fer from simply completing the exercise protocol in the absence of blood
ow restriction. This is important because higher perceptual responses,
despite the effectiveness of blood ow restriction, may deter its use in
practice.
2. Methods
2.1. Participants
Twenty-six resistance trained participants (20 men, 6 women) com-
pleted all of the testing sessions. Individuals were classied as resis-
tance trained if they performed resistance training two or more days
per week for at least the past 6 months in the upper body. All partici-
pants were instructed to refrain from: 1) eating 2 h prior in all visits;
2) consuming caffeine 8 h prior to all visits; 3) consuming alcohol
24 h prior to all visits; and 4) upper body exercise 24 h before all visits.
Participants were excluded if they had more than one risk factor for
thromboembolism [14] which included the following: obesity
(BMI 30 kg/m2); diagnosed Crohn's disease; a past fracture of the
hip, pelvis or femur; major surgery within the last 6 months; varicose
veins; a family or personal history of deep vein thrombosis or pulmo-
nary embolism. Also, participants who were currently using tobacco
products were excluded. The study received approval from the
University's institutional review board and each participant gave writ-
ten informed consent before participation.
2.2. Study design
During visit 1, the participants lled out an informed consent form,
adult health history questionnaire and physical activity readiness ques-
tionnaire (PAR-Q). After conrming that they did not meet any exclu-
sion criteria, height and body mass were measured using a standard
stadiometer and an electronic scale. Next, the participants were seated
in a quiet room for 10 min. Following the rest period, participants had
their standing arterial occlusion pressure determined in both arms at
the radial artery in a randomized fashion. The participants then tested
their unilateral concentric elbow exion one-repetition maximum
(1RM) for each arm and were then familiarized with isometric testing.
Following this, participants were familiarized with the blood ow re-
striction stimulus. After visit 1, participants were scheduled for their
testing visits with a minimum of ve and a maximum of 10 days be-
tween visits at the same time of day. During visits 2, 3, and 4, partici-
pants performed two exercise conditions of unilateral elbow exion in
combination with blood ow restriction at 30% of their concentric
1RM in a random order (one condition per arm). The participants
exercised at 0%, 10%, 20%, 30%, 50%, or 90% of their standing resting ar-
terial occlusion pressure. The goal repetitions for the exercise protocol
consisted of one set of 30 repetitions followed by three sets of 15 repe-
titions with 30 s rest periods between sets. Upon completion of the nal
set, arterial occlusion pressure was determined again. A metronome
was used to ensure that the participants held the cadence of 1 s for
the concentric muscle action and 1 s for the eccentric muscle action dur-
ing the unilateral elbow exion exercise. Ratings of perceived exertion
(RPE) and discomfort were taken prior to (pre) and following each set
of exercise.
2.3. Determination of arterial occlusion pressure
Following 10 min of seated rest, arterial occlusion was measured on
both arms. The arm randomly assigned to exercise rst, was measured
rst. The cuff was then removed and placed on the other arm to deter-
mine resting arterial occlusion for that limb. The cuff used was a 5 cm
wide nylon cuff applied to the most proximal portion of the arm. The
lowest pressure at which blood ow at the radial artery was no longer
present was determined in the standing position using a Doppler
hand-held probe (MD6 Doppler Probe, Hokanson, Bellevue, WA, USA).
Pressure was regulated by the E20 Rapid Cuff Inator (Hokanson, Belle-
vue, WA) and was inated to 50 mm Hg before being progressively in-
creased by 1 mm Hg increments until a pulse was no longer detected.
The participants exercised with the cuff in place and upon completion
of the exercise, the applied pressure was increased until blood ow
was no longer present and the cuff was deated immediately. Thirty
minutes after the rst condition, the participants were seated in a
quiet room for 5 min. Following the rest period, participants had
their standing arterial occlusion pressure determined on the arm
that was not trained rst and then that arm completed an additional
exercise protocol. Although the arterial occlusion pressure was deter-
mined in this arm after the rst 10 min rest, the arterial occlusion
pressure used for exercise was based on the assessment obtained
immediately prior to exercise in that arm. This was done to ensure
that if there was an augmented cardiovascular response from the
rst exercise condition, it would be accounted for by the new base-
line. It should be noted that there were only minor differences
between the rst and second measurements [mean difference (95%
CI); 5 (46) mm Hg].
2.4. One-repetition maximum testing
A one-repetition maximum (1RM) for the unilateral elbow exion
exercise was obtained on both arms for each individual on visit 1. Brief-
ly, participants warmed up with a relatively low load corresponding to
an estimated 30% 1RM. Following the brief warm-up, the load was in-
creased to approximately 90% of the individuals 1RM and participants
performed one repetition. Thereafter, the load was adjusted to an esti-
mated 1RM and the load was either increased or decreased in 0.5 kg in-
crements until a 1RM was obtained. The dumbbell was handed to each
individual at full elbow extension and participants were instructed to
keep their back and heels against the wall during all 1RM attempts to
ensure strict form. Only those attempts that maintained proper form
were counted.
2.5. Ratings of perceived exertion (RPE)
RPE was taken before the start of exercise and immediately follow-
ing each set using the standard Borg 620 scale as previously described
[15]. Participants were explained in depth how to rate their RPE and to
ensure they understood the scale being used. Participants were told,
We want you to rate your perception of exertion, that is, how heavy
and strenuous the exercise feels to you. The perception of exertion de-
pends mainly on the strain and fatigue in your muscles. We want you
to use this scale from 6-20, where 6 means no exertion at all and 20
means maximal exertion; any questions? Participants conrmed
that they fully understood how to rate RPE prior to actual testing. RPE
was taken immediately after sets 1, 2, 3 and 4.
 K.T. Mattocks et al. / Physiology & Behavior 171 (2017) 181186 183

2.6. Ratings of discomfort

A rating of discomfort was taken prior to the start of exercise and fol-
lowing each set using the Borg Discomfort scale (CR-10+) as described
previously [15]. For example, participants were asked, What was your
worst experiences of discomfort? Maximum discomfort (rating of 10)
is your main point of reference; it is anchored by your previously expe-
rienced worst discomfort. The worst discomfort that you have ever ex-
perienced, the Maximum discomfort may not be the highest possible
level of discomfort. There may be a level of discomfort that is still stron-
ger than your 10; if this is the case, you will say 11 or 12. If the discom-
fort is much stronger, for example, 1.5 times Maximum Discomfort you
will say 15; any questions? Participants conrmed that they fully un-
derstood how to rate discomfort prior to actual testing. Ratings of dis-
comfort were taken before exercise, as well as 20 s after sets 1, 2, 3,
and immediately after set 4. Discomfort was taken 20 s after each set be-
cause participants in previous blood ow restriction studies anecdotally
noted greater discomfort later in the rest periods. Fig. 1. Mean arterial occlusion pressure before (pre) and immediately after exercise (post).
An asterisk indicates a signicant difference from pre-to-post (p 0.05). Conditions with
2.7. Statistical analysis different letters represent signicant differences between conditions for post values
(p 0.05). If two conditions contain at least one of the same letter, they are not
signicantly different from each other. Data represented as mean (95% CI).
All data were analyzed using the SPSS 22 statistical software package
(SPSS Inc., Chicago, IL). For arterial occlusion pressure, a 6 (condition) 2
(time) repeated measures of analysis of variance (ANOVA) was con- 24.616, p b 0.001), and 4 (2 = 29.334, p b 0.001) of exercise with the
ducted. If there was a signicant interaction, paired sample t-tests de- RPE generally being greater at the higher applied pressures.
termined differences from pre-to-post exercise within each condition
and one-way repeated measures ANOVAs determined differences
3.4. Ratings of discomfort
across conditions within each time point. To compare differences in
the perceptual responses (RPE and discomfort), a Friedman non-
There were no differences in ratings of discomfort at pre (Table 1,
parametric test was used to determine if differences existed between
2 = 2.722, p = 0.743); however, there were signicant differences
conditions at different time points (Pre, 1st set, 2nd set, 3rd set, 4th
across conditions for sets 1 (2 = 48.820, p b 0.001), 2 (2 = 58.885,
set). If there were signicant differences, Wilcoxon related samples
p b 0.001), 3 (2 = 58.724, p b 0.001), and 4 (2 = 55.748, p b 0.001)
nonparametric tests were used to determine where the difference oc-
with the ratings of discomfort generally being greater at the higher ap-
curred. For exercise volume, a one-way repeated measures ANOVA de-
plied pressures.
termined differences in exercise volume across conditions. All data are
presented as means and 95% condence intervals except for the percep-
tual responses which are represented as 50th (25th, 75th) percentiles. 3.5. Exercise volume
Statistical signicance was set at an alpha level 0.05.
There was a signicant difference between conditions (F = 22.526,
3. Results p b 0.001) in exercise volume, with the higher restriction pressures
completing less volume compared to lower restriction pressures (Fig.
3.1. Participants 3). When displayed as total repetitions completed across arterial occlu-
sion pressures [mean (95% CI)], the majority of individuals were unable
A total of 26 resistance trained males (n = 20) and females (n = 6) to complete the goal number of repetitions [0%: 65 (6269); 10%: 65
[mean (95% CI); Age: 22 (2123) yrs; Height: 175.3 (171.2179.4) cm: (6169); 20%: 65 (6169); 30%: 64 (6068); 50%: 62 (5867); and
Body mass: 78.7 (73.484.1) kg; Left arm 1RM: 22.6 (19.925.4) kg; 90%: 50 (4455) repetitions].
Right arm 1RM: 22.9 (20.124.6) kg] completed the study protocol.

3.2. Arterial occlusion pressure

There was a signicant condition time interaction with arterial oc-

clusion pressure (F = 3.527, p = 0.014). Follow up tests found that all
conditions increased arterial occlusion pressure from pre to post
(p b 0.001). No signicant differences were noted between conditions
at pre (F = 0.461, p = 0.805), however, differences between conditions
were found at post (Fig. 1, F = 4.128 p = 0.002). Supplementary Fig. 1
displays the pre-post change score (95% CI) in arterial occlusion pres-
sure across relative pressures. Given the increase in arterial occlusion
pressure with exercise, there were noted decreases in the relative ap-
plied pressure which is displayed in Fig. 2.

3.3. Ratings of perceived exertion (RPE)

There were no differences in RPE at pre (Table 1, 2 = 3.5, p =

0.623); however, there were signicant differences across conditions Fig. 2. Relative applied arterial occlusion pressure differences from pre to post. Data
for sets 1 (2 = 18.893, p b 0.05), 2 (2 = 30.364, p b 0.001), 3 (2 = represented as mean (95% CI).
184 K.T. Mattocks et al. / Physiology & Behavior 171 (2017) 181186

Table 1
Perceptual responses to differing levels of arterial occlusion pressure. Sets with different letters represent signicant differences between pressures (p 0.05). If conditions contain at least
one of the same letter, they are not signicantly different from each other. Values are represented as median (25th, 75th percentile).

Ratings of perceived exertion

% Arterial occlusion Pre Set 1 Set 2 Set 3 Set 4

0% 6 (6, 6) 12 (9, 14) a 13 (12, 15) ab 14.5 (12.75, 17) abc 14.5 (13, 17) a
10% 6 (6, 6) 10 (9, 13) b 12 (9, 15) b 14 (11, 16) c 13.5 (12, 17) a
20% 6 (6, 6) 11 (9, 13.5) ab 13 (11, 15.5) abcdef 14 (11, 16) c 15 (12, 16.25) a
30% 6 (6, 6) 13 (9.75, 14) abc 14, (12, 15.5) af 15 (13, 16.25) b 15 (13, 16.25) a
50% 6 (6, 6) 12.5 (11, 14) c 14 (12.5 16) cdef 15 (13.75, 17) b 15 (13, 17) a
90% 6 (6, 6) 13 (9.75, 15) c 15 (13, 16.5) g 16 (14.5 17.5) d 17 (14.75, 19) b
Ratings of discomfort
% Arterial occlusion Pre Set 1 Set 2 Set 3 Set 4
0% 0 (0, 0) 2 (0.5, 3) a 3 (0.875, 3) a 3 (1, 4.5) a 3.5 (1.5, 6.25) a
10% 0 (0, 0) 1 (0.45, 3) a 2 (0.650, 3) ab 2.5 (0.85, 4.5) a 3 (1, 6) ab
20% 0 (0, 0) 1.75 (0.5, 3) a 2 (0.925, 3) b 2.5 (1.25, 4) a 3 (1.375, 4) b
30% 0 (0, 0) 2 (0.65, 3) ab 2.75 (1.5, 4.25) a 3 (2, 5) a 3.5 (2.375, 6) ac
b
50% 0 (0, 0) 2.25 (0.925, 3) 3.5 (1.875, 5) c 4 (2, 6.5) b 4.5 (3, 7) c
90% 0 (0, 0) 4.5, (2.75, 6) c 5 (3.75, 7) d 7 (5, 9) c 7 (4.5, 9) d

4. Discussion 8 cm wide cuff) produced a response in between that observed with

The current study uncovered three ndings: 1) the application of a
relative restriction pressure decreases following upper body exercise
due to an augmented cardiovascular response, 2) perceptual responses
were signicantly different across conditions and for all sets with the
higher relative pressure coinciding with the greatest ratings of RPE
and discomfort, and 3) exercise volume was different between condi-
tions with the higher relative pressure completing less volume com-
pared to the lower relative pressures.
The current study sought to further investigate the change in the
cardiovascular response to six different relative restriction pressures
following 4 sets of blood ow restriction exercise. It has recently been
observed by Brandner et al. [16] that blood ow restricted exercise
(10.5 cm wide cuff used for exercise) with intermittent high-pressure
(130% systolic blood pressure measured with an 8 cm wide cuff) caused
a similar hemodynamic (i.e. heart rate, blood pressure, cardiac output,
rate pressure product) response compared to traditional high load exer-
cise. Further, they observed that exercise in combination with low-
continuous pressure (80% systolic blood pressure measured with an
Fig. 3. Average total exercise volume completed across conditions. Conditions with
different letters represent signicant differences between conditions (p 0.05). If two
conditions contain at least one of the same letter, they are not signicantly different
from each other. Data represented as mean (95% CI).
high load and low load exercise. This suggests that when performing
blood ow restriction exercise, greater levels of blood ow restriction
will augment the cardiovascular response but not necessarily augment
the muscle adaptation [9,11]. Additionally, low-intensity aerobic exer-
cise in combination with blood ow restriction has demonstrated a
greater increase in the cardiovascular response compared to exercise
without blood ow restriction [17]. However, the restriction pressure
applied to the participants in the aforementioned studies were not
made relative to the participant or the cuff used during the exercise
which may have had some individuals under complete arterial occlu-
sion. This augmented cardiovascular response could be due to the me-
chanical compression of the vascular tree which may augment the
exercise-induce pressor response [18]. Although the magnitude of
change in pressure may not be of concern to a healthy participant, this
may be more concerning for aging individuals and/or individuals with
a compromised cardiovascular system (e.g. hypertension). It can be hy-
pothesized that applying a lower relative pressure may maximize mus-
cle adaptation while causing less mechanical compression. Less
mechanical compression may minimize the exercise-induced pressor
response which may lessen the chances of an adverse event [4,8]. How-
ever, it is also important to understand that the relative restriction pres-
sure will decrease with exercise. Thus, a pressure sufcient at the
beginning of exercise may no longer restrict the same amount of
blood ow following exercise. A previous study found that the relative
restriction pressure of 40% arterial occlusion pressure decreased ~ 8%
immediately after a bout of blood ow restriction exercise in the
upper body indicating an increase in the cardiovascular response during
exercise [12]. In agreement with the previous study, we also observed a
decrease in the relative restriction pressure following a bout of upper
body exercise with the addition of incorporating multiple levels of
blood ow restriction pressures. Examining the cardiovascular response
to this type of exercise can help determine an appropriate restriction
pressure to minimize the exaggerated cardiovascular response while
maximizing muscular adaptation.
In regards to perceptual responses (RPE and discomfort), there is
limited information on RPE throughout different levels of restriction
pressures [10,19,20]. Yasuda et al. [19] applied two different pressures
to the participants when performing unilateral bicep curls and observed
that a restriction pressure of 160 mm Hg induced a higher RPE com-
pared to 100 mm Hg; however, these pressures were not individualized
to the cuff or participant. Therefore, some individuals may have been
fully occluded with 160 mm Hg which may have augmented their
RPE. Conversely, when applying a relative restriction pressure based
on the participant's arterial occlusion pressure [10,20], there were no
differences in RPE. While applying a relative restriction pressure to the
participants in the current study, however, there were differences in
 K.T. Mattocks et al. / Physiology & Behavior 171 (2017) 181186
RPE. A possible reason for the discrepancy between Loenneke et al. [10,
20] and the current study is that the authors in that study applied mod-
erate to high restriction pressures while we applied low to high restric-
tion pressures. Although the pressures applied were randomized,
participants had a greater probability of exercising at a lower restriction
pressure (4 conditions compared to 1 condition) before exercising at a
higher restriction pressure. For example, the participant may have re-
ceived a relative restriction pressure of b 40% in the rst condition and
used the ratings from this condition as their anchor for subsequent pres-
sures; thus, when receiving a relative restriction pressure of 90% their
ratings were altered due to the large difference in mechanical compres-
sion (or vice versa).
The results from the current study display that discomfort ratings
were greatest when a higher relative pressure (90% arterial occlusion
pressure) was applied which agrees with a previous study conducted
by Counts et al. [9]. The authors of that study examined discomfort in
the upper body at 40% and 90% arterial occlusion pressure and found
that 90% arterial occlusion pressure resulted in a greater rating of dis-
comfort. Interestingly, however, the results from our study and Counts
et al. [9] differ from Loenneke et al. [10] where there were little differ-
ences in discomfort with pressures ranging 40%90% arterial occlusion
pressure. There are a few possible reasons for the divergences between
the studies. Counts et al. [9] examined untrained participants while
Loenneke et al. [10] examined resistance trained individuals which sug-
gests training status may be playing some role. There were also differ-
ences in baseline 1RM between the two studies which may suggest
that the pressure applied may have less of an impact on the ratings of
discomfort in those who are training with an overall higher absolute
load (Baseline 1RM: Counts et al. 11.2 kg; Loenneke et al. ~ 19 kg).
We examined resistance trained individuals with similar strength levels
(Baseline 1RM: 22.9 kg) as Loenneke et al. [10] but observed an in-
creased discomfort at the higher relative pressures. Possible reasons
for the discrepancy between the current study and the aforementioned
study could be that they examined relative pressures ranging from
moderate to high while the current study examined relative pressures
ranging from low to high. It may be that participants could not notice
a big difference between moderate to high relative pressures applied
(40%, 50%, 60%, 70%, 80%, and 90% arterial occlusion) due to the small in-
creased increments of pressures applied which resulted in little differ-
ences in ratings of discomfort between pressures. Thus, similar to RPE,
part of the discrepancy may be due to the probability that lower pres-
sures were experienced rst altering the subsequent ratings of the
higher pressure condition or vice versa.
5. Limitations
In view of the results presented herein, our study has some limita-
tions. We measured the pressure required for resting arterial occlusion
but did not quantify the change in blood ow. Future studies should
quantify the change in blood ow through different levels of relative re-
striction pressures in-between sets and/or arterial occlusion pressure to
determine where the change is occurring. Additionally, we used a 5 cm
nylon cuff and it is possible that these results could differ with cuffs of
different widths. It may be that a wide cuff, inated to a relative pres-
sure, may still induce a greater cardiovascular or perceptual response
since it covers up both more area of the muscle as well as more of the
vascular structures. Regardless, the results of the present study are spe-
cic to 5 cm wide nylon cuffs.
6. Conclusion
Applying a relative restriction pressure based on arterial occlusion
pressure during blood ow restriction exercise has been shown to pro-
duce favorable adaptations while also ensuring a common stimulus. It
appears for muscular adaptations, 40% arterial occlusion [9] is all that
is required at 30% 1RM; however, the cardiovascular response is
185
different depending on the relative restricted pressure applied. Current-
ly it is unknown whether pressures b40% arterial occlusion pressure
with a load of 30% 1RM induces similar muscular and vascular adapta-
tions compared to moderate and high pressures. The current investiga-
tion sought to characterize the cardiovascular and perceptual responses
to blood ow restriction exercise through different levels of restriction
pressures. Applying a lower relative restriction pressure resulted in
lower perceptual responses which may be more appealing to individ-
uals and result in better adherence to blood ow restriction exercise. Fu-
ture research could investigate if a lower load (20% 1RM) and different
levels of pressures produce different or similar cardiovascular and per-
ceptual responses. Overall, these results provide additional information
to the blood ow restriction literature by categorizing the cardiovascu-
lar and perceptual response to pressures b 40% arterial occlusion. In ad-
dition, these ndings may guide future studies to provide a safer and
more tolerable stimulus for the individual who still wants to increase
muscle size while concomitantly minimizing the cardiovascular
response.
Supplementary data to this article can be found online at http://dx.
doi.org/10.1016/j.physbeh.2017.01.015.
Acknowledgements
This study was supported in part by the Biolayne foundation (SJD
and JPL).
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