Lower body blood flow restriction training may induce remote muscle strength adaptations in an active unrestricted arm

Anthony K. May, Aaron P. Russell, Stuart A. Warmington

Research output: Contribution to journalArticleResearchpeer-review

30 Citations (Scopus)


Purpose: We examined the concurrent characteristics of the remote development of strength and cross-sectional area (CSA) of upper body skeletal muscle in response to lower body resistance training performed with an applied blood flow restriction (BFR). Methods: Males allocated to an experimental BFR group (EXP; n = 12) or a non-BFR control group (CON; n = 12) completed 7-weeks of resistance training comprising three sets of unilateral bicep curls [50% 1-repetition maximum (1-RM)], then four sets of bilateral knee extension and flexion exercises (30% 1-RM). EXP performed leg exercises with an applied BFR (60% limb occlusion pressure). 1-RM strength was measured using bilateral leg exercises and unilateral bicep curls in both trained and untrained arms. Muscle CSA was measured via peripheral quantitative computed tomography in the dominant leg and both arms. Results: 1-RM in the trained arm increased more in EXP (2.5 ± 0.4 kg; mean ± SEM) than the contralateral untrained arm (0.8 ± 0.4 kg), and the trained arm of CON (0.6 ± 0.3 kg, P < 0.05). The increase in knee extension 1-RM was twofold that of CON (P < 0.01). Knee flexion 1-RM, leg CSA, and trained arm CSA increased similarly between groups (P > 0.05), while untrained arm CSA did not change (P > 0.05). Conclusion: Lower limb BFR training increased trained arm strength more than the contralateral untrained arm, and the trained arm of controls. However, there was no additional effect on muscle CSA. These findings support evidence for a BFR training-derived remote strength transfer that may be relevant to populations with localised movement disorders.

Original languageEnglish
Pages (from-to)617-627
Number of pages11
JournalEuropean Journal of Applied Physiology
Issue number3
Publication statusPublished - 1 Mar 2018
Externally publishedYes


  • Blood flow restriction
  • Hypertrophy
  • Remote
  • Resistance
  • Strength

Cite this