Sprint training in hypoxia and with blood flow restriction: Controversies and perspectives

This narrative review assesses the effects of repeated sprint training (RST) in hypoxia (RSH) and blood flow restriction (BFR) methods on skeletal muscle adaptations and performance. Current literature suggests that RSH promotes metabolic modifications in muscle cells, especially driven by reactive oxygen species production, HIF-1α stabilization, and changes in metabolism. Training with BFR promotes metabolite accumulation in working muscles due to limited blood flow, however, cellular mechanisms affected by BFR during RST are less explored. Data highlight that RSH improves repeated sprint ability (RSA) in several sport disciplines (e.g. rugby, tennis, soccer, cross-country skiing). However, recent studies showed that addition of hypoxia or BFR during RST did not promote supplementary benefits on aerobic performance, force-velocity power profile, and $\dot{V}{O}_2\max$. Nonetheless, gains in $\dot{V}{O}_2$max were observed during sprint interval training protocols when BFR was applied during recovery between sets. Finally, recent studies highlighted that RSH can improve RSA in a short period. Thus, RSH and sprint training with BFR may be useful for sports disciplines requiring high glycolytic demand and can promote gains in RSA in a short window. Further studies must be encouraged to better understand the biological consequences of adding such stimuli to exercise, especially BFR, on long-term adaptation.