BFR Rope Training in Male Volleyball Players

Official title

The Effects of Blood Flow Restriction Rope Training on Athletic Performance, Muscle Strength, and Hypertrophy in Male Volleyball Players

Overview

The study will be conducted during the preparatory period of the volleyball players and will span eight weeks. Throughout this period, athletes will continue their regular volleyball training four days per week, while the experimental group (n = 10) will perform rope training with blood flow restriction (BFR) twice per week, and the control group (n = 10) will perform the same rope training without BFR. Assessments will be carried out at the beginning of the 8-week period (pre-test) and at the end of the intervention (post-test). For both groups, all exercises will target the upper-extremity muscle groups. During the study, participants will be instructed to avoid consuming any medications, engaging in additional strenuous physical activities, and using any techniques or ergogenic aids that might influence the results. In both testing sessions, a standardized warm-up protocol will be implemented, consisting of a 5-minute treadmill run at 9 km/h on a Sprint Runner device (Hoggan Health Industries, Draper, UT), followed by 3 minutes of light full-body stretching. This warm-up procedure will be applied consistently across both groups to ensure standardization.

Detailed description

This study aims to investigate the effects of blood flow restriction (BFR) rope training on athletic performance, muscle strength, and muscle hypertrophy in male volleyball players through an eight-week intervention. Conducted during the athletes' preparatory period, the study requires participants to perform rope-training sessions four days per week in addition to their regular volleyball training. On the first day, all athletes will undergo anthropometric measurements, and a familiarization session will be conducted to minimize potential learning effects. Participants will then be randomly assigned to either a BFR rope-training experimental group (BFR) or a control group (CON) performing standard rope training. Both groups will follow a progressive training protocol consisting of three sets and five exercises, while the BFR group will train under a cuff pressure set at 60% of limb occlusion pressure (LOP). Throughout the training sessions, heart rate, rating of perceived exertion (RPE), perceived discomfort (PD), OMNI-RES exercise difficulty, and PACES exercise enjoyment scores will be recorded. Pre- and post-intervention assessments will include ultrasound measurements of muscle thickness and cross-sectional area, one-repetition maximum (1RM) tests for biceps and triceps, upper-body strength tests (push-ups, sit-ups, and squats), shoulder strength using a Lafayette device, handgrip strength, aerobic endurance via the Yo-Yo IR1 test, anaerobic performance via the Wingate test, and volleyball serve speed measurements. All exercises will target upper-extremity muscle groups, and participants will be instructed to refrain from using any medications, ergogenic aids, or additional strenuous exercise that could influence outcomes. During both pre- and post-testing sessions, all athletes will complete a standardized warm-up protocol consisting of a 5-minute treadmill run at 9 km/h followed by 3 minutes of light full-body stretching. This comprehensive design aims to provide valuable insights into how BFR-based rope training influences performance adaptations in volleyball athletes.

Interventions

• Other Blood Pressure
  A digital Omron device (model M2; Ankara, Turkey) will be used to measure participants' resting blood pressure. Prior to exercise, systolic, diastolic, and heart rate values will be recorded, and individuals outside the 140/90 mmHg range will be excluded. Participants will remain seated for 10 minutes, after which three measurements will be taken from the dominant arm with at least 1 minute between readings. Resting blood pressure will be calculated as the average of these three values, followin
• Other Muscle Strength
  Dominant and non-dominant shoulder internal and external rotation strength will be assessed using a Lafayette digital handheld dynamometer. This portable device provides peak force, time to peak force, total test duration, and average force in kilograms, Newtons, and pounds. Participants will receive verbal instructions and complete a familiarization trial before testing. The "make test" technique will be used, in which the examiner stabilizes the device while the participant applies maximal iso
• Other Serve Speed
  The serve speed test will be conducted in the Hasan Doğan Sports Sciences Gymnasium at Karabük University using official balls (FIVB Beach Championship VLS300 MIKASA). Athletes will begin with a 15-minute warm-up consisting of joint mobility exercises (e.g., knee flexion/extension, shoulder rotation, ankle dorsiflexion), followed by technical movements such as ball-free jumping and running to enhance coordination. Each player will then perform ten practice serves. A total of 196 power-kick serve
• Other Blood Flow Restriction
  The arterial occlusion pressures (AOP) of the athletes randomized to the experimental group will be automatically determined using a digital LED-display BFR device (Fit Cuffs BFR, Denmark). Optimal cuff width, occlusion pressure, and exercise procedures have been previously described in the literature (Loenneke et al., 2015; Scott et al., 2015). A 4-inch-wide tourniquet will be applied to the upper arm of the participant's dominant limb. During the exercise, the AOP will be maintained at 60% usi
• Other Rating of Perceived Exertion
  After each training session, RPE will be collected using the 6-20 Borg Scale at the end of the session, where 6 indicates "no exertion" and 20 indicates "maximal exertion" (Foster et al., 2021).
• Other Battle Rope Training
  Based on prior literature recommending battle ropes measuring 12-15 m in length, 3-5 cm in diameter, and 9-16 kg in weight (Pustina et al., 2017; Tessitore et al., 2006; Ziy et al., 2009), this study will use a 12-m, 3.8-cm diameter, 12-kg rope. Participants will perform wave-style rope exercises in a standing position with feet shoulder-width apart and the trunk flexed forward at approximately 30-45°. The rope will be anchored at its midpoint to a stable object, and participants will grip the e
• Other Arm Circumference
  Before the training session and without performing any physical activity, arm circumference will be measured using a 300-cm non-elastic measuring tape. Measurements will be taken at a 90° elbow angle from the midpoint of the upper arm, over the biceps muscle (Otman, 2003).
• Other Skeletal Muscle Endurance
  Upper-body and trunk muscular endurance will be assessed using standardized ACSM protocols. Upper-body endurance will be measured with the ACSM push-up test: men will perform standard push-ups, while women will complete kneeling push-ups. The test will stop at volitional fatigue or after two consecutive form errors (chin to mat and full elbow extension). Trunk endurance will be evaluated using the cadence-based YMCA bent-knee sit-up test, performed at one repetition every 2 seconds until volitio
• Other Anaerobic Power
  The Wingate Anaerobic Power Test (WAnT) is a widely used 30-second cycling test designed to measure short-term, high-intensity power output and anaerobic energy system capacity (Reiser et al., 2002). Conducted on a Monark 894E ergometer, the test uses a resistance load adjusted to each participant's body mass (Jaafar et al., 2014). Before testing, participants will complete a 4-5 minute warm-up at 60-70 W and 60-70 rpm, including 2-3 short sprints, followed by 3-5 minutes of passive rest. Saddle
• Other Bench Press 1RM Test
  Participants will begin with a 5-minute treadmill warm-up at 9 km/h followed by three minutes of light stretching (do Carmo et al., 2021). A specific warm-up will then be performed: 5 reps at 50% of estimated 1RM, followed by 1-2 sets of 2-3 reps at 60-80%. After warm-up, participants will perform single-rep attempts with gradually increasing loads to determine their 1RM, resting 3-5 minutes between trials. Up to five attempts will be used to identify the true 1RM (Schoenfeld et al., 2016).

Primary outcome measures

• Muscle Thickness (Ultrasound) - Biceps, Triceps, Brachialis, Antrerior Deltoid, Upper Trapezius, Rectus Abdominis [Time frame: From baseline assessment to 8-week follow-up assessment]
• Muscle Cross-Sectional Area (CSA) - Biceps, Triceps, Brachialis, Antrerior Deltoid, Upper Trapezius, Rectus Abdominis [Time frame: From baseline assessment to 8-week follow-up assessment.]
• 1-Repetition Maximum (1RM) - Bench Press and Triceps Push-Down [Time frame: From baseline assessment to 8-week follow-up assessment.]
• Shoulder Internal/External Rotation Strength [Time frame: From baseline assessment to 8-week follow-up assessment]
• Hand Grip Strength [Time frame: From baseline assessment to 8-week follow-up assessment.]
• Upper-Body Muscular Endurance - Push-Up, Sit-Up, Pull-Up [Time frame: From baseline assessment to 8-week follow-up assessment]
• Serve Speed [Time frame: From baseline assessment to 8-week follow-up assessment]
• Aerobic Intermittent Endurance - Yo-Yo IR1 [Time frame: From baseline assessment to 8-week follow-up assessment]
• Anaerobic Power - Wingate Test [Time frame: From baseline assessment to 8-week follow-up assessment]
• Perceived Exertion - RPE (Borg 6-20) [Time frame: From baseline assessment to 8-week follow-up assessment]

Secondary outcome measures (4)

• Anthropometric Measurements 1 [Time frame: Baseline]
• Anthropometric Measurements 2 [Time frame: Baseline]
• Anthropometric Measurements 3 [Time frame: Baseline]
• Anthropometric Measurements 4 [Time frame: Baseline]

Eligibility criteria

Inclusion criteria

• Being healthy
• Male volleyball athletes
• Willing to maintain the intervention for all sessions

Exclusion criteria

• Being under 18 years old
• Having a chronic disease
• Contraindications for exercise

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Turkey (Türkiye) · 1 center

• Karabuk University — Karabük

Publications

• Kamis O, Rolnick N, de Queiros VS, Akcay N, Keskin K, Yildiz KC, Sofuoglu C, Werner T, Hughes L. Impact of limb occlusion pressure assessment position on performance, cardiovascular, and perceptual responses in blood flow restricted low-load resistance exercise: A randomized crossover trial. J Sports Sci. 2025 Oct;43(19):2256-2264. doi: 10.1080/02640414.2024.2422205. Epub 2024 Nov 10. PMID 39523480
• Keskin K, Akcay N, Ozmen T, Contarli N, Yildiz KC, Sofuoglu C, Kamis O, Rolnick N, de Queiros VS, Montoye A. Effects of different pre-exercise strategies on jumping performance in female volleyball players. J Sports Med Phys Fitness. 2025 Jan;65(1):59-68. doi: 10.23736/S0022-4707.24.16196-8. Epub 2024 Oct 3. PMID 39360986

Identifiers

NCT: NCT07327177 · UKarabuk-5

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗