A 8 weeks, single-blinded randomized controlled trial will be conducted at Pakistan Sports Board (PSB). Forty-four athletes (18-35 years) will be randomized into Group A (HL-RT + BFR, n = 22) and Group B (HL-RT only, n = 22). BFR will be applied at 50% limb occlusion pressure during lower-body exercises (squats, leg press). Both groups trained 3x/week for 4 weeks at 70-80% 1RM. Outcomes included 1RM strength, squat endurance, push-up performance, and International Physical Activity Questionnaire (IPAQ) scores.
Participants with age between 18 and 35 years.
Active individual participating in sport activities at least 3 times a week for the past 6 months.
Participants with any non-heart conditions.
Individuals voluntarily participating and providing informed consent.
Individuals with DVT or other pulmonary artery disease.
Pregnant women or those planning to become pregnant.
Participants with recent musculoskeletal injuries (within the 6 months).
Individuals currently involved in another study.
Parallel
Heavy-Load Resistance Training with Blood Flow Restriction
Other interventionBlood Flow Restriction (BFR) Training (also known as "Kaatsu" training is an innovative and increasingly popular exercise technique to improve muscle strength and hypertrophy with relatively low loads. Heavy Load Resistance Training (HL-RT) is one of the most effective exercise methodology that is widely used to increase muscular strength and hypertrophy.
Heavy-Load Resistance Training Only
Other interventionHeavy Load Resistance Training (HL-RT) is one of the most effective exercise methodology that is widely used to increase muscular strength and hypertrophy.
1RM strength
The 1 Repetition Maximum (1 RM) Testing protocol determines quadriceps maximal strength through identifying the maximum weight an individual can lift in a single attempt with exercises that include the leg press or squat and leg extension movements.
Squat Endurance
Experts have established the validity of 3-5 RM squats as a strength test because they correlate strongly with quadriceps force output and exhibit excellent reliability (ICC \> 0.90) through standardization of stance and depth and rest periods. Maximal bodyweight squats at 60-70% 1 RM or to complete failure serve as reliable (ICC \~0.70-0.85) and moderate tests of endurance even though hip and core involvement affects validity.
Push Up Performance
The push-up test is largely used to evaluate upper body endurance and strength (chest, shoulders, triceps) without much activation of the quadriceps and should not be considered as an indicator of quad endurance or strength. On standard push ups though, quads serve only as stabilizers which means it does not provide much of contribution than exercise such as squatting or doing leg extensions. Push-ups can still be considered a reliable test (ICC \~0.80-0.90) for upper body muscular endurance but cannot be used to assess quadriceps function
International Physical Activity Questionnaire (IPAQ) scores
International Physical Activity Questionnaire (IPAQ). Interpretation: Higher score indicates increased physical activity in athletes. Effect of interpretation: BFR with heavy load training significantly increases physical activity levels as compared to control. Description: The International Physical Activity Questionnaire - short form (IPAQ-SF) will be used to assess a participant's total physical activity levels. This self-report tool estimates MET-minutes per week across various domains. The score ranges from 0 to an upper limit, with higher scores indicating greater levels of physical activity.
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