Decrements in Neuromuscular Function Are Reduced Following Low-Load Continuous Blood Flow Restriction Exercise Compared With High-Load Resistance Exercise

ABSTRACT: Davids, CJ, Raastad, T, Geneau, MC, James, LP, Lichtwark, G, Coombes, JS, Peake, JM, and Roberts, LA. Decrements in neuromuscular function are reduced following low-load continuous blood flow restriction exercise compared to high-load resistance exercise. J Strength Cond Res 40(5): 552-559, 2026-The aim of this study was to quantify neuromuscular fatigue during and following resistance exercise protocols varying in load and blood flow restriction (BFR) application. Twelve strength-trained male subjects performed 4 sets of squat exercises under 4 conditions: (a) low-load resistance exercise (LL-RE, 30% one-repetition maximum [1RM]), (b) high-load resistance exercise (HL-RE, 70% 1RM), (c) LL-RE with continuous BFR (BFR-C), and (d) LL-RE with intermittent BFR (BFR-I). Neuromuscular fatigue markers included repetition velocity, isometric knee extensor torque, jump performance, and quadriceps contractile properties. Effort perceptions were also recorded. Statistical significance was set at p < 0.05. Repetition velocities slowed with HL-RE (-8 ± 5%) and BFR-C (-4 ± 11%), significantly differing from LL-RE (7 ± 5%) and BFR-I (3 ± 5%). Effort ratings increased significantly across all conditions (all p < 0.01), with higher ratings observed during HL-RE and BFR-C compared with LL-RE and BFR-I for all 4 sets (all p < 0.01). At 60 minutes postexercise, knee extensor torque was reduced more with HL-RE (-8 ± 10%) than BFR-C (-6 ± 11%), and evoked contraction torque showed a similar pattern (HL-RE: -18 ± 12%; BFR-C: -5 ± 12%). Jump height declined across all conditions but was significantly greater following HL-RE (-13 ± 6%). Both HL-RE and BFR-C induced neuromuscular fatigue, slowing repetition velocities and elevating effort perceptions, but impairments were more pronounced with HL-RE after 60 minutes. Blood flow restriction-C may be a valuable alternative in athletic contexts where loading and/or postexercise fatigue must be managed.