Local and Systemic Responses to Low-Intensity Cycling With Blood Flow Restriction Compared to High-Intensity Cycling: A Randomized Crossover Study.

Despite growing interest in blood flow restriction (BFR) for enhancing training adaptations, its acute impacts on local and systemic physiological stress remain incompletely understood. This study compared the metabolic and perceptual responses of low-intensity cycling (LI) with BFR (LI + BFR) to both LI and high-intensity (HI) cycling without BFR, matched for time and external work. Ten males (26.9 ± 4.6 years) completed LI (20 min at 55% peak aerobic power output, PPO), LI + BFR (with 50% limb occlusion pressure), and HI (10 × 1 min at 90% PPO interspersed with 1-min recovery at 20% PPO) protocols in a randomized cross-over design. Interstitial metabolic responses were assessed via microdialysis in the vastus lateralis; systemic blood responses were evaluated via venous blood gas analysis. Cardiorespiratory responses, including heart rate, oxygen uptake, and ventilation, were continuously monitored during exercise. Serum creatine kinase (CK) and lactate dehydrogenase (LDH) were measured as indirect markers of muscle damage, and perceptual responses were documented. Muscle interstitial lactate and pyruvate were highest in HI, followed by LI + BFR, and lowest in LI (p < 0.05). Systemic blood and cardiorespiratory responses were comparable between LI + BFR and HI and exceeded LI (p < 0.05), while electrolyte shifts occurred across all conditions (p < 0.001) without between-condition differences. All protocols increased CK and LDH 24-48 h post-exercise, with the greatest increases in HI (p < 0.05). Perceived exertion and pain were higher in LI + BFR than in other conditions (p < 0.05). In conclusion, BFR intensifies local and systemic stress during LI and may be a potent strategy to promote muscle adaptive stimulus. However, when time and total external work are matched, high mechanical loading appears more effective in inducing local stress, which may be essential for further muscular adaptation processes.