{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T22:02:39Z","timestamp":1783980159999,"version":"3.55.0"},"reference-count":83,"publisher":"Wiley","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"abstract":"\n Abstract<\/jats:title>\n \n We investigated how blood flow restriction (BFR) training enhances performance and neuromuscular function during dynamic exercise through adaptations in vascular function, mitochondrial respiratory capacity and metaboreflex\u2010related haemodynamic responses. Eleven healthy active participants completed 6\u00a0weeks of interval training with one leg under BFR (BFR\u2010leg; cuff pressure:165\u00a0\u00b1\u00a036\u00a0mmHg) and the other without (CTRL\u2010leg). Before and after training, participants performed single\u2010leg knee\u2010extensor incremental tests to determine peak power output (\n W<\/jats:italic>\n max<\/jats:sub>\n ) and constant workload trials at 90% pre\u2010training\n W<\/jats:italic>\n max<\/jats:sub>\n to assess neuromuscular fatigue [maximal voluntary contraction (MVC) and evoked contractile force\u00a0(QT)]. Blood flow responsiveness was evaluated using Doppler ultrasound during reactive hyperaemia (RH), passive leg movement (PLM) and rapid\u2010onset vasodilatation (ROV). Mitochondrial respiratory capacity was estimated indirectly from post\u2010exercise recovery kinetics of muscle oxygen consumption (). Mean arterial pressure (MAP) and heart rate (HR) responses to metaboreflex activation during exercise and post\u2010exercise circulatory occlusion (PECO) were measured. After training,\n W<\/jats:italic>\n max<\/jats:sub>\n increased \u223c17% more in the BFR\u2010leg than in the CTRL\u2010leg (\n P<\/jats:italic>\n \u00a0<\u00a00.001). Exercise\u2010induced reductions in MVC (\n P<\/jats:italic>\n \u00a0<\u00a00.001) and QT forces (\n P\u00a0=\u00a0<\/jats:italic>\n 0.001) were less in the BFR\u2010trained leg than CTRL\u2010leg, indicating less fatigue development. Femoral blood flow was higher in the BFR\u2010leg during RH and ROV (\n P<\/jats:italic>\n \u00a0<\u00a00.001), but not PLM. MAP (\n P\u00a0=\u00a0<\/jats:italic>\n 0.001) and HR (\n P<\/jats:italic>\n \u00a0<\u00a00.001) responses were lower in the BFR\u2010leg during exercise with muscle metaboreflex activation, without training or leg differences during PECO (\n P<\/jats:italic>\n \u00a0>\u00a00.230). The kinetics of improved similarly in both legs (\n P\u00a0<\/jats:italic>\n <\u00a00.007). Compared to the control, BFR interval training elicited greater improvements in performance and less fatigue for equivalent exercise through integrated neuromuscular, vascular and metabolic adaptations.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n Interval training with blood flow restriction (BFR) improves exercise performance by enhancing oxygen delivery and muscle homeostasis in contracting muscles, but its effects on neuromuscular fatigue and the underlying mechanisms are not fully understood.<\/jats:p>\n <\/jats:list-item>\n \n In a within\u2010subject, unilateral design, participants trained one leg with BFR for 6\u00a0weeks while the contralateral leg served as a control. Before and after training, we assessed neuromuscular fatigue, vascular function, near\u2010infrared spectroscopy (NIRS)\u2010derived post\u2010exercise recovery kinetics of muscle oxygen consumption (, a surrogate for mitochondrial respiratory capacity) and muscle metaboreflex activation.<\/jats:p>\n <\/jats:list-item>\n \n BFR interval training attenuated neuromuscular fatigue development during high\u2010intensity dynamic knee\u2010extensor exercise, mainly by reducing impairments in peripheral (i.e. muscle) fatigue.<\/jats:p>\n <\/jats:list-item>\n \n After BFR training, leg blood flow was greater during vascular function tests compared to the control, suggesting enhanced haemodynamic function.<\/jats:p>\n <\/jats:list-item>\n \n Less fatigue for equivalent exercise occurred independently of changes in NIRS\u2010derived and appears to be largely driven by peripheral neuromuscular and vascular adaptations.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp289806","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T12:48:32Z","timestamp":1765370912000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Physiological mechanisms underlying enhanced performance with blood flow restriction training: neuromuscular, vascular and metabolic adaptations"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9885-4028","authenticated-orcid":false,"given":"Colin","family":"Lavigne","sequence":"first","affiliation":[{"name":"Universit\u00e9 C\u00f4te d'Azur LAMHESS Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6784-1467","authenticated-orcid":false,"given":"Valentin","family":"Mons","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d'Azur LAMHESS Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Lemineur","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d'Azur LAMHESS Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1405-0194","authenticated-orcid":false,"given":"Oliver","family":"Meste","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d'Azur CNRS, Laboratoire I3S Sophia Antipolis France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georges","family":"Lefth\u00e9riotis","sequence":"additional","affiliation":[{"name":"University Hospital Nice Vascular Physiology and Medicine Unit Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9417-8349","authenticated-orcid":false,"given":"Gr\u00e9gory M.","family":"Blain","sequence":"additional","affiliation":[{"name":"Universit\u00e9 C\u00f4te d'Azur LAMHESS Nice France"},{"name":"Department of Biology Utah Valley University Orem UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"issue":"3","key":"e_1_2_5_2_1","first-page":"452","article-title":"Effects of low\u2010intensity cycle training with restricted leg blood flow on thigh muscle volume and VO2max in young men","volume":"9","author":"Abe T.","year":"2010","journal-title":"Journal of Sports Science and Medicine"},{"issue":"1","key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1113\/jphysiol.2007.141838","article-title":"Locomotor muscle fatigue modifies central motor drive in healthy humans and imposes a limitation to exercise performance","volume":"586","author":"Amann M.","year":"2008","journal-title":"The Journal of Physiology"},{"issue":"3","key":"e_1_2_5_4_1","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1113\/jphysiol.2006.113936","article-title":"Arterial oxygenation influences central motor output and exercise performance via effects on peripheral locomotor muscle fatigue in humans","volume":"575","author":"Amann M.","year":"2006","journal-title":"The Journal of Physiology"},{"issue":"1","key":"e_1_2_5_5_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1113\/jphysiol.1985.sp015794","article-title":"Maximal perfusion of skeletal muscle in man","volume":"366","author":"Andersen P.","year":"1985","journal-title":"The Journal of Physiology"},{"issue":"5","key":"e_1_2_5_6_1","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1152\/japplphysiol.00166.2018","article-title":"Understanding near infrared spectroscopy and its application to skeletal muscle research","volume":"126","author":"Barstow T. 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