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Effects of Blood Flow Restriction Walking on Distal and Contralateral Lower Limb Muscles: A Nonrandomized Clinical Trial With a Within-Subject Approach

Year: 2026

Type: article

Abstract: BACKGROUND: Blood flow restriction (BFR) training effectively improves strength in muscles directly subjected to occlusion. Secondary effects on distal and contralateral muscles remain underexplored. HYPOTHESIS: A walking training program plus BFR applied to the upper thigh enhances muscle strength in distal muscles of the lower leg. STUDY DESIGN: Nonrandomized controlled clinical trial with a within-subject approach. LEVEL OF EVIDENCE: Level 1. METHODS: A total of 20 male and 12 female adults (31.1 ± 9.5 years) with ≥10% strength asymmetry in knee extensors completed 3 weekly sessions over 12 weeks. A cuff inflated at 90% of total occlusion pressure was applied to the weaker limb (exercised segment [ES]); the stronger limb served as control segment (CS). Outcomes assessed pre- and postintervention included ankle plantarflexor and dorsiflexor strength and muscle thickness (MT) (medial gastrocnemius [MG] and tibialis anterior [TA]) using isometric testing and ultrasound. RESULTS: > 0.05). In the ES, the MG changed from 1.93 cm to 2.04 cm and TA from 2.06 cm to 2.33 cm. In the CS, the MG remained stable (1.99 cm to 2.02 cm), and TA varied from 2.12 cm to 2.35 cm. CONCLUSION: Walking combined with BFR targeting the upper thigh improves strength in distal muscles of the lower leg, with notable gains in both the occluded and contralateral segments. Neural adaptations likely account for the observed strength increases. CLINICAL RELEVANCE: BFR walking is an effective, low-impact intervention to enhance lower-limb muscle strength, with potential applications in rehabilitation and training for people with asymmetry or muscle weakness.

Source: Sports Health A Multidisciplinary Approach

DOI: 10.1177/19417381261421485

Authors: Letícia Pophal Cutisque, Caio Corso Silveira, Francisco Wekerlin Morozowski, Natália Boneti Moreira, André Luiz Felix Rodacki

Institution: Universidade Federal do Paraná

Language: English

Topic: Cardiovascular and exercise physiology

Subfield: Complementary and alternative medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funder: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior