Acute muscle swelling effects of a knee rehabilitation exercise performed with and without blood flow restriction

This study assessed the acute effect of adding blood flow restriction (BFR) to quad sets on muscle-cross sectional area (mCSA), muscle thickness (MT), echo intensity (EI), and subcutaneous fat-normalized EI (EINORM) of the superficial quadriceps muscles. Twelve males and 12 females (mean±SD; age (yrs): 21.4±2.9; stature (m): 1.76±0.1; body mass (kg): 77.7±2.9) performed 70 repetitions (one set of 30, three sets of 15 repetitions) of bodyweight quad sets separately on each leg, with or without BFR (CON) applied. Rating of perceived exertion was recorded following each set. Panoramic ultrasound images of the vastus lateralis (VL), vastus medialis (VM), and rectus femoris (RF) were captured prior to (PRE), immediately after (IMM-POST), 30- (30-POST), and 60-minutes after (60-POST) after exercise. Sex x condition x time repeated measures ANOVAs assessed differences at p<0.05 for each muscle and dependent variable separately. Although males had larger VM and VL mCSA and VL MT (p<0.05), there were no acute changes from PRE to IMM-POST (p>0.05). There was a 3-way interaction in VL mCSA (p = 0.025) which indicated BFR was greater than CON at IMM-POST by 7.6% (p = 0.019) for males only. Females had greater EI in the VM and VL than males (p<0.05), yet males had greater EINORM for each muscle (p>0.05) and EINORM did not change over time or treatment (p>0.05). The lack of changes in MT, EI, and EINORM indicate that unloaded quad sets do not provide a stimulus to promote fluid shifts or acute changes in muscle size with the exception of IMM-POST in the VL for males. Future research should attempt to elucidate the acute muscular responses of BFR application for lightly loaded rehabilitation exercises in the clinical populations for which they are prescribed.