Effects of Blood Flow Restriction Training on Physical Function, Muscle Adaptations, and Performance in Roller Skaters

Official title

Effects of Blood Flow Restriction Training on Neuromuscular Function, Jump Performance, and Dynamic Balance Under Non-Fatigued and Fatigued Conditions, and on Muscle Morphology, Body Composition, Strength, Physiological Responses, Anaerobic Performance, and Roller Skating-Specific Performance in Competitive Roller Skaters

Overview

This randomized controlled trial evaluates the effects of adding blood flow restriction training to regular roller skating training on neuromuscular function under non-fatigued and fatigued conditions, muscle morphology, body composition, physiological responses, lower-limb strength, and roller skating performance in competitive roller skaters. Thirty participants aged 18 to 25 years will be randomly assigned to either a blood flow restriction training group or a regular training control group. Both groups will complete the same standardized 10-week roller skating training program. The blood flow restriction training group will wear pressure cuffs individualized according to each participant's arterial occlusion pressure during selected training sessions three times per week, while the control group will complete the same training without blood flow restriction. Before and after the intervention, participants will complete standardized assessments of muscle morphology using musculoskeletal ultrasound, body composition using dual-energy X-ray absorptiometry, and lower-limb strength using handheld dynamometry and one-repetition maximum tests. Physiological responses will be evaluated using blood lactate concentration and heart rate variability. Roller skating performance will be assessed using sprint, repeated-sprint, and endurance skating tests. Neuromuscular function, jump performance, and balance will also be assessed under both non-fatigued and fatigued conditions. Surface electromyography and force-platform data will be collected simultaneously during selected jump and single-leg balance tasks. The Y-Balance Test will be conducted separately without surface electromyography. The study aims to determine whether blood flow restriction training improves muscle and neuromuscular adaptations, body composition, strength, physiological responses, and roller skating performance, and whether it helps roller skaters maintain neuromuscular function, jump performance, and balance during fatigue.

Detailed description

This study is a randomized, parallel-group controlled trial designed to evaluate the effects of blood flow restriction training added to regular roller skating training in competitive roller skaters.

Thirty participants aged 18 to 25 years will be recruited and randomly assigned to either a blood flow restriction training group or a regular training control group. Both groups will complete the same standardized roller skating training program for 10 weeks. Participants in the blood flow restriction training group will wear blood flow restriction cuffs during selected portions of regular training three times per week for approximately 20 to 30 minutes per session. Cuff pressure will be individualized according to each participant's arterial occlusion pressure. Participants in the control group will complete the same training content, frequency, and duration without blood flow restriction.

Assessments will be conducted before and after the 10-week intervention using the same standardized procedures. Because the assessment battery includes multiple physiological, morphological, neuromuscular, and performance measures, baseline and post-intervention testing will each be completed over three separate sessions.

The first assessment session will evaluate basic anthropometric characteristics, lower-limb muscle morphology, body composition, and strength. Musculoskeletal ultrasound will be used to assess prespecified lower-limb muscle morphology, including muscle thickness, muscle volume, and pennation angle. Dual-energy X-ray absorptiometry will be used to assess body composition and bone-related measures. Lower-limb strength will be assessed using handheld dynamometry, maximal voluntary contraction testing, and one-repetition maximum tests.

The second assessment session will evaluate neuromuscular function, jump performance, and balance under both non-fatigued and fatigued conditions. Surface electromyography and force-platform data will be collected simultaneously during selected jump, landing, and single-leg balance tasks. The Y-Balance Test will be conducted separately without surface electromyography. After completion of the non-fatigued assessments, participants will undergo a cycle ergometer-based fatigue protocol followed by a standardized roller skating-specific fatigue protocol. Fatigue status will be determined using blood lactate concentration, heart rate, rating of perceived exertion, power output, and task performance. Once the predefined fatigue criteria are reached, participants will repeat the relevant neuromuscular, jump, and balance assessments.

The third assessment session will evaluate roller skating-specific performance using short-distance sprint skating tests, repeated-sprint skating tests, and an endurance skating test. Physiological responses, including blood lactate concentration and heart rate variability, will also be assessed at prespecified time points.

Training attendance, heart rate, rating of perceived exertion, internal training load, participant discomfort, and adverse events will be monitored throughout the intervention. The study will compare changes from baseline to post-intervention between the blood flow restriction training group and the control group and will also examine whether blood flow restriction training reduces fatigue-related declines in neuromuscular function, jump performance, and balance.

Interventions

• Behavioral Blood Flow Restriction Roller Skating Training
  Participants will complete a 10-week standardized roller skating training program. During regular roller skating training, participants will wear blood flow restriction cuffs three times per week for 20 minutes per session. Cuff pressure will be individualized according to each participant's arterial occlusion pressure and progressively increased according to a prespecified protocol: 40% of arterial occlusion pressure during weeks 1-2, 50% during weeks 3-4, and 60% during weeks 5-10. Progression
• Behavioral Standardized Roller Skating Training
  Participants will complete a 10-week standardized roller skating training program with the same training content, frequency, duration, and monitoring procedures as the experimental group, but without blood flow restriction. Training attendance, heart rate, rating of perceived exertion, discomfort, and adverse events will be monitored throughout the intervention.

Primary outcome measures

• Change From Baseline in Ultrasound-Derived Lower-Limb Muscle Morphology [Time frame: Baseline and Week 10 (post-intervention)]
• Mean Change From Baseline in Normalized Mean RMS Amplitude During Single-Leg Countermovement Jump Without Arm Swing [Time frame: Baseline and Week 10 (post-intervention), assessed before and immediately after the standardized fatigue-induction protocol]
• Mean Change From Baseline in Normalized Mean RMS Amplitude During Squat Jump With Hands on Hips [Time frame: Baseline and Week 10 (post-intervention), assessed before and immediately after the standardized fatigue-induction protocol]
• Mean Change From Baseline in Normalized Mean RMS Amplitude During Five Consecutive Countermovement Jumps [Time frame: Baseline and Week 10 (post-intervention), assessed before and immediately after the standardized fatigue-induction protocol]
• Mean Change From Baseline in Normalized Mean RMS Amplitude During Ten Consecutive Straight-Leg Jumps [Time frame: Baseline and Week 10 (post-intervention), assessed before and immediately after the standardized fatigue-induction protocol]
• Mean Change From Baseline in Normalized Mean RMS Amplitude During Left- and Right-Leg Lateral Bound [Time frame: Baseline and Week 10 (post-intervention), assessed before and immediately after the standardized fatigue-induction protocol at each assessment]
• Mean Change From Baseline in the Fatigue-Induced Change in Normalized Mean RMS Amplitude of the Gluteus Medius During Bilateral Countermovement Jump With Hands on Hips [Time frame: Baseline and Week 10 (post-intervention), with measurements obtained before and immediately after the standardized fatigue-induction protocol at each assessment]
• Mean Change From Baseline in Medial Gastrocnemius Pennation Angle at 30% of Lower-Leg Length at Rest [Time frame: Baseline and Week 10 (post-intervention)]
• Mean Change From Baseline in Average Pennation Angle Across Seven Prespecified Lower-Limb Ultrasound Site-Condition Combinations [Time frame: Baseline and Week 10 (post-intervention)]
• Mean Change From Baseline in Average Muscle Thickness Across Seven Prespecified Lower-Limb Ultrasound Site-Condition Combinations [Time frame: Baseline and Week 10 (post-intervention)]

Secondary outcome measures (12)

• Change From Baseline in Force-Platform-Derived Jump and Single-Leg Balance Outcomes Under Non-Fatigued and Fatigued Conditions [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Dynamic Balance Assessed by the Y-Balance Test Under Non-Fatigued and Fatigued Conditions [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Body Composition and Bone Mineral Density Assessed by Dual-Energy X-Ray Absorptiometry [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Lower-Limb and Trunk Maximal Isometric Strength Assessed by Handheld Dynamometry [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Lower-Limb One-Repetition Maximum Strength [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Surface Electromyographic Activity During Maximal Voluntary Contractions [Time frame: Baseline and Week 10 (post-intervention)]
• Change From Baseline in Blood Lactate Response to Fatigue Induction [Time frame: Baseline and Week 10 (post-intervention), assessed before fatigue induction, immediately after fatigue induction, and 20 minutes after fatigue induction]
• Change From Baseline in Roller Skating-Specific Performance [Time frame: Baseline and Week 10 (post-intervention)]
• Incidence of Intervention-Related Adverse Events [Time frame: Throughout the 10-week intervention]
• Change From Baseline in Heart Rate Variability Response and Recovery Following Exercise [Time frame: Baseline and Week 10 (post-intervention), assessed before exercise, immediately after exercise, and 20 minutes after exercise]
• Change From Baseline in Fatigue-Induced Change in Bilateral Mean Normalized Anterior Reach Distance [Time frame: Baseline and Week 10 (post-intervention), assessed under non-fatigued and fatigued conditions]
• Change From Baseline in Fatigue-Induced Change in Bilateral Mean Normalized Posteromedial Reach Distance [Time frame: Baseline and Week 10 (post-intervention), assessed under non-fatigued and fatigued conditions]

Eligibility criteria

Inclusion criteria

• Aged 18 to 25 years.
• Currently active or trained competitive roller skaters with regular roller skating-specific training experience who meet at least one of the following criteria:

• Hold a Chinese National Athlete Grade II classification or higher; or
• Have completed at least 2 years of continuous roller skating-specific training, maintained systematic training during the previous year, and participated in provincial-level competitions.
• In good general health, without known cardiovascular, peripheral vascular, respiratory, neurological, metabolic, or coagulation disorders, a history of thrombosis, severe varicose veins, severe hypertension, or other conditions that may affect the safety of blood flow restriction training or high-intensity exercise testing.
• No acute or unresolved chronic injury involving the joints, muscles, ligaments, tendons, or bones of the lower limbs, and no clinically significant lower-limb pain that would interfere with roller skating, jumping, or balance testing.
• Able to safely complete roller skating-specific testing, jump and balance testing, cycle ergometer-based fatigue induction, and standardized roller skating-specific fatigue induction.
• Intact and healthy skin on the thighs, without wounds, infection, skin disease, severe allergy, or other conditions that may interfere with blood flow restriction cuff placement or surface electromyography electrode application.
• Stable sleep, training, and recovery status during the week before testing, without evidence of marked fatigue, inadequate recovery, persistent muscle soreness, substantial performance decline, severe sleep insufficiency, or serious psychological distress.
• A pain score of 0 to 3 on the Numeric Rating Scale and a pretest rating of perceived exertion of 12 or lower.
• No use during the previous week of medications, nutritional supplements, or sports supplements that may affect cardiovascular function, muscle metabolism, blood lactate, heart rate variability, neuromuscular activation, fatigue responses, or exercise performance.
• Familiar with the roller skating-specific testing procedures and able to follow all testing and training instructions.
• Willing to undergo blood flow restriction training and all required assessments.
• Able to understand the study procedures, provide written informed consent, and voluntarily participate.

Exclusion criteria

• Age outside the range of 18 to 25 years or failure to meet the required roller skating training, athlete classification, systematic training, or competition-experience criteria.
• Cardiovascular disease, peripheral vascular disease, respiratory disease, neurological disease, metabolic disease, coagulation disorder, history of thrombosis, severe varicose veins, severe hypertension, circulatory impairment, or another contraindication to blood flow restriction training or high-intensity exercise testing.
• Acute lower-limb musculoskeletal injury or an unresolved chronic injury that prevents safe completion of the testing or fatigue-induction procedures.
• Clinically significant lower-limb pain, severe sleep insufficiency, inadequate recovery, suspected overtraining, serious psychological distress, or another condition that may compromise participant safety or data validity.
• Use during the previous week of medications, nutritional supplements, or sports supplements that may affect the study outcomes.
• Skin wounds, infection, skin disease, severe allergy, or another condition affecting blood flow restriction cuff placement or surface electromyography electrode application.
• Inability to understand or comply with the study procedures or to safely complete the required surface electromyography, force-platform, Y-Balance, jump, and fatigue-induction assessments.
• Refusal to undergo blood flow restriction training or any required study procedure.
• Failure to provide written informed consent.

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

Basic science

Study locations

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07736157 · 102772026RT120

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗