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

This study investigated the effect of limb occlusion pressure (LOP) position on exercise performance, cardiovascular responses, and perceptual experiences during seated bilateral leg extensions with and without blood flow restriction (BFR). Thirty resistance-trained males (age: 22 ± 2 years; weight: 74.4 ± 13.6 kg; height: 177.4 ± 6.4 cm; BMI: 23.5 ± 3.3 kg/m²) participated. Each performed exercise to failure (4 sets, 30% 1RM, 1 min rest) in three conditions: Supine LOP-BFR, Seated LOP-BFR, and no-BFR. BFR was applied at 60% LOP. Significant interaction effects were found for RPE (p = 0.021, d = 0.76), RPD (p < 0.01, d = 1.72), and DOMS (p < 0.01, d = 2.28). Statistically significant fewer repetitions were completed in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.5), Seated LOP-BFR vs. no-BFR (p < 0.01, d = 1.0), and Seated LOP-BFR vs. Supine LOP-BFR (p < 0.01, d = 0.6). RPE was higher in Seated LOP-BFR vs. no-BFR (p < 0.01, d = 0.52). RPD was higher in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.62) and Seated LOP-BFR vs. no-BFR (p < 0.01, d = 1.25). DOMS was higher in Supine LOP-BFR vs. no-BFR (p < 0.01, d = 0.77) and Seated LOP-BFR vs. no-BFR (p < 0.01, d = 3.52). Seated LOP-BFR increased perceptual demands and reduced repetitions compared to Supine LOP-BFR. Both LOP-BFR conditions reduced repetitions compared to no-BFR without affecting cardiovascular measures.