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Our hypothesis was that LL\u2010BFR training triggers augmented gains in knee muscle strength and size, which are paralleled with transcriptional responses of hypoxia\u2010regulated genes and myokines. Eighteen volunteers (age 37.5\u00a0\u00b1\u00a09\u00a0years) planned for ACL reconstruction, participated in the study. Twelve were divided between BFR group, performing 9 sessions of LL\u2010BFR exercise, and SHAM\u2010BFR group performing equal training with sham vascular occlusion. Six subjects served as a control for muscle biopsy analysis. Cross\u2010sectional area (CSA) and isokinetic strength of knee muscles were assessed before and after the training. Change in CSA<jats:sub>quad<\/jats:sub> was significantly (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.01) larger in BFR (4.9%) compared with SHAM\u2010BFR (1.3%). Similarly, change in peak torque of knee extensors was significantly (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.05) larger in BFR (14%) compared with SHAM\u2010BFR (\u22121%). The decrease in fatigue index of knee extensors (6%) was larger (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.01) in BFR than in SHAM\u2010BFR (2%). mRNA expression of HIF\u20101\u03b1 in the vastus lateralis was reduced (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.05) in SHAM\u2010BFR, while VEGF\u2010A mRNA tended to be higher in BFR. The mRNA expression of myostatin and its receptor were reduced (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.05) in the semitendinosus after both types of training. Expression of IL\u20106, its receptors IL\u20106R\u03b1 and gp130, as well as musclin were similar in control and training groups. In conclusion, our results show augmented strength and endurance of knee extensors but less of the flexors. LL\u2010BFR training is especially effective for conditioning of knee extensors in this population.<\/jats:p>","DOI":"10.1111\/sms.13968","type":"journal-article","created":{"date-parts":[[2021,4,10]],"date-time":"2021-04-10T08:26:59Z","timestamp":1618043219000},"page":"1636-1646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Functional and molecular adaptations of quadriceps and hamstring muscles to blood flow restricted training in patients with ACL rupture"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8241-2997","authenticated-orcid":false,"given":"Alan","family":"Kacin","sequence":"first","affiliation":[{"name":"Department of Physiotherapy Faculty of Health Sciences University of Ljubljana  Ljubljana Slovenia"},{"name":"Institute of Pathophysiology Faculty of Medicine University of Ljubljana  Ljubljana 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