This randomized controlled trial evaluates the effects of adding blood flow restriction training to regular roller skating training on neuromuscular function under non-fatigued and fatigued conditions, muscle morphology, body composition, physiological responses, lower-limb strength, and roller skating performance in competitive roller skaters.
Thirty participants aged 18 to 25 years will be randomly assigned to either a blood flow restriction training group or a regular training control group. Both groups will complete the same standardized 10-week roller skating training program. The blood flow restriction training group will wear pressure cuffs individualized according to each participant's arterial occlusion pressure during selected training sessions three times per week, while the control group will complete the same training without blood flow restriction.
Before and after the intervention, participants will complete standardized assessments of muscle morphology using musculoskeletal ultrasound, body composition using dual-energy X-ray absorptiometry, and lower-limb strength using handheld dynamometry and one-repetition maximum tests. Physiological responses will be evaluated using blood lactate concentration and heart rate variability. Roller skating performance will be assessed using sprint, repeated-sprint, and endurance skating tests.
Neuromuscular function, jump performance, and balance will also be assessed under both non-fatigued and fatigued conditions. Surface electromyography and force-platform data will be collected simultaneously during selected jump and single-leg balance tasks. The Y-Balance Test will be conducted separately without surface electromyography.
The study aims to determine whether blood flow restriction training improves muscle and neuromuscular adaptations, body composition, strength, physiological responses, and roller skating performance, and whether it helps roller skaters maintain neuromuscular function, jump performance, and balance during fatigue.
Aged 18 to 25 years.
Hold a Chinese National Athlete Grade II classification or higher; or
Have completed at least 2 years of continuous roller skating-specific training, maintained systematic training during the previous year, and participated in provincial-level competitions.
In good general health, without known cardiovascular, peripheral vascular, respiratory, neurological, metabolic, or coagulation disorders, a history of thrombosis, severe varicose veins, severe hypertension, or other conditions that may affect the safety of blood flow restriction training or high-intensity exercise testing.
Age outside the range of 18 to 25 years or failure to meet the required roller skating training, athlete classification, systematic training, or competition-experience criteria.
Cardiovascular disease, peripheral vascular disease, respiratory disease, neurological disease, metabolic disease, coagulation disorder, history of thrombosis, severe varicose veins, severe hypertension, circulatory impairment, or another contraindication to blood flow restriction training or high-intensity exercise testing.
Acute lower-limb musculoskeletal injury or an unresolved chronic injury that prevents safe completion of the testing or fatigue-induction procedures.
Clinically significant lower-limb pain, severe sleep insufficiency, inadequate recovery, suspected overtraining, serious psychological distress, or another condition that may compromise participant safety or data validity.
Parallel
Blood Flow Restriction Roller Skating Training
BehavioralParticipants will complete a 10-week standardized roller skating training program. During regular roller skating training, participants will wear blood flow restriction cuffs three times per week for 20 minutes per session. Cuff pressure will be individualized according to each participant's arterial occlusion pressure and progressively increased according to a prespecified protocol: 40% of arterial occlusion pressure during weeks 1-2, 50% during weeks 3-4, and 60% during weeks 5-10. Progression to the next pressure stage will occur only if the participant tolerates the current pressure without excessive discomfort or abnormal responses. Training attendance, heart rate, rating of perceived exertion, pressure-related discomfort, and adverse events will be monitored throughout the intervention.
Standardized Roller Skating Training
BehavioralParticipants will complete a 10-week standardized roller skating training program with the same training content, frequency, duration, and monitoring procedures as the experimental group, but without blood flow restriction. Training attendance, heart rate, rating of perceived exertion, discomfort, and adverse events will be monitored throughout the intervention.
Change From Baseline in Ultrasound-Derived Lower-Limb Muscle Morphology
A GE LOGIQ e portable ultrasound system will be used to assess the morphology of prespecified lower-limb muscles using standardized anatomical locations, participant positioning, transducer placement, and image-acquisition procedures. Outcomes will include muscle thickness measured in millimeters, pennation angle measured in degrees, and estimated muscle volume measured in cubic centimeters. Repeated measurements obtained during each assessment will be averaged for analysis. Changes from baseline to Week 10 will be compared between the blood flow restriction training group and the active control group.
Mean Change From Baseline in Normalized Mean RMS Amplitude During Single-Leg Countermovement Jump Without Arm Swing
A Cometa wireless surface electromyography system (REF WP180R116PCC1) will record activity of the gluteus medius, biceps femoris, vastus medialis, vastus lateralis, medial gastrocnemius, and tibialis anterior during left- and right-leg single-leg countermovement jumps performed without arm swing. Mean root mean square amplitude will be calculated over the prespecified movement epoch and normalized to maximal voluntary contraction, expressed as a percentage of MVC. Valid trials will be averaged. Values will be reported separately by muscle, test limb, and fatigue condition; no cross-muscle or cross-limb composite will be calculated. Change from baseline will be calculated as the Week 10 value minus the baseline value.
Mean Change From Baseline in Normalized Mean RMS Amplitude During Squat Jump With Hands on Hips
A Cometa wireless surface electromyography system (REF WP180R116PCC1) will record activity of the gluteus medius, biceps femoris, vastus medialis, vastus lateralis, medial gastrocnemius, and tibialis anterior during the squat jump performed with the hands maintained on the hips throughout the movement. Mean root mean square amplitude will be calculated over the prespecified movement epoch and normalized to maximal voluntary contraction, expressed as a percentage of MVC. Valid trials will be averaged. Values will be reported separately for each muscle and fatigue condition; no cross-muscle composite will be calculated. Change from baseline will be calculated as the Week 10 value minus the baseline value.
Mean Change From Baseline in Normalized Mean RMS Amplitude During Five Consecutive Countermovement Jumps
A Cometa wireless surface electromyography system (REF WP180R116PCC1) will record activity of the gluteus medius, biceps femoris, vastus medialis, vastus lateralis, medial gastrocnemius, and tibialis anterior during five consecutive countermovement jumps. Mean root mean square amplitude will be calculated separately for each jump over the prespecified movement epoch and normalized to maximal voluntary contraction, expressed as a percentage of MVC. The five repetition-specific values will be averaged. Values will be reported separately for each muscle and fatigue condition; no cross-muscle composite will be calculated. Change from baseline will be calculated as the Week 10 value minus the baseline value.
Change From Baseline in Force-Platform-Derived Jump and Single-Leg Balance Outcomes Under Non-Fatigued and Fatigued Conditions
A KWYB-FP6050 three-dimensional force platform will be used to assess prespecified jump, landing, and single-leg balance tasks under non-fatigued and fatigued conditions. The tasks will include the countermovement jump, single-leg countermovement jump, squat jump, five consecutive squat jumps, 10 consecutive straight-leg jumps, lateral jumps, and single-leg balance. Outcomes will include center-of-pressure displacement and velocity, ground reaction force variables, and related kinetic and postural-control measures. Changes from baseline to Week 10 will be compared between the blood flow restriction training group and the active control group. Fatigue-related changes within each assessment and between-group differences in these changes will also be evaluated.
Change From Baseline in Dynamic Balance Assessed by the Y-Balance Test Under Non-Fatigued and Fatigued Conditions
A Y Balance Test Kit (Functional Movement Systems, Inc.) will be used to assess lower-limb dynamic balance under non-fatigued and fatigued conditions. Normalized reach distances in the anterior, posteromedial, and posterolateral directions, as well as the composite reach score, will be recorded for each lower limb. Changes from baseline to Week 10 will be compared between the blood flow restriction training group and the active control group. Fatigue-related changes within each assessment and between-group differences in these changes will also be evaluated.
Change From Baseline in Body Composition and Bone Mineral Density Assessed by Dual-Energy X-Ray Absorptiometry
A GE Lunar iDXA dual-energy X-ray absorptiometry system will be used to assess body composition and bone mineral density. Outcomes will include lean mass measured in kilograms, fat mass measured in kilograms, body fat percentage, and bone mineral density measured in grams per square centimeter. Changes from baseline to Week 10 will be compared between the blood flow restriction training group and the active control group.
Change From Baseline in Lower-Limb and Trunk Maximal Isometric Strength Assessed by Handheld Dynamometry
A microFET3 handheld dynamometer will be used to assess maximal isometric strength during prespecified lower-limb and trunk movements, including ankle dorsiflexion and plantar flexion, knee extension and flexion, hip flexion and extension, hip abduction and adduction, and trunk rotation. Testing will be conducted using standardized participant positions, joint angles, stabilization procedures, and verbal instructions. Force will be recorded in newtons. Repeated valid trials for each movement will be summarized according to the prespecified testing protocol. Changes from baseline to Week 10 will be compared between the blood flow restriction training group and the active control group.
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