The goal of this clinical trial is to investigate the short-term effect of lower limb BFRT on the somatosensory processing and related changes in SSEP amplitude and latency. The main questions it aims to answer are:
* Is there an effect of short-term application of BFRT on the somatosensory system? * How do different cuff widths affect the somatosensory system? * How do three different cuff widths affect perceived pain? Researchers will compare 3 different cuff widths to see if different cuff widths affect the somatosensory system and perceived pain.
Participants will:
* Undergo 3 experimental sessions, sessions will be separated by 72 hours and the order of the sessions to be randomly selected. * Perform low-load resistance training with blood flow restriction.
Participants will be included if they are aged 18-30 years of both genders, with no history of cardiovascular problems or osteo-articular problems in the lower limbs, and if they responded negatively to all items of the Physical Activity Readiness Questionnaire (PAR-Q).
Participants will be included if they have a body mass index (BMI) less than 25 or non-overweight individuals.
Use of the long international physical activity questionnaire (L-IPAQ) to ensure all participants have equal physical activity levels.
Participants will be excluded if they did not meet the inclusion criteria, and if they had a history of deep vein thrombosis (DVT), congenital heart disease, varicose veins, currently pregnant, or any contraindications to exercise.
Participants will be excluded if they were diagnosed with any neurological disease.
Participants will be excluded if they have had any musculoskeletal injury in the past 3 months to avoid potential effect on their physical activity levels.
Crossover
Passive application of BFR cuff
Other interventionThe first experimental session will start by conducting the one repetition maximum (1-RM) test of unilateral knee extension of the dominant leg, in which the dominant side was identified by asking the participants which side they will use to kick a ball. Before conducting the 1-RM test, 5 minutes warm-up on the cycle ergometer at 75W will be done. Calibration of the dynamometer will be done before operating the machine with each participant, then the participant will be positioned on the dynamometer seat comfortably with ensuring the back is supported and the knee is aligned with the axis of rotation. The participant will be asked to complete one successful repetition of knee extension through full range of motion (ROM), with increasing load until the participant can no longer complete full knee extension ROM, 3 minutes of rest will be allowed between attempts until the 1-RM is identified.
Resistance exercise with BFR
Other interventionFor both experimental sessions 2 and 3, the order of exercise condition will be randomly selected, either to be (1) the application of BFR cuff with resistance exercise, or (2) resistance exercise without the application of BFR cuff to decrease the incidence of learning effect. Cuff pressure during the application of BFR will be standardized to 50% of AOP. The resistance exercise for both experimental sessions 2 and 3 will be exactly similar and will involve four sets of isometric knee extensions at an intensity of 20% of 1-RM with repetitions of 30, 15, 15, and 15 by using the isokinetic dynamometer machine, which has a good to excellent test-retest reliability for knee extension movement with ICC value of 0.95-0.99. To minimize cognitive and neuromuscular fatigue, the experimental sessions will be separated by a minimum of three days (72 hours).
Resistance exercise without BFR
Other interventionFor both experimental sessions 2 and 3, the order of exercise condition will be randomly selected, either to be (1) the application of BFR cuff with resistance exercise, or (2) resistance exercise without the application of BFR cuff to decrease the incidence of learning effect. Cuff pressure during the application of BFR will be standardized to 50% of AOP. The resistance exercise for both experimental sessions 2 and 3 will be exactly similar and will involve four sets of isometric knee extensions at an intensity of 20% of 1-RM with repetitions of 30, 15, 15, and 15 by using the isokinetic dynamometer machine, which has a good to excellent test-retest reliability for knee extension movement with ICC value of 0.95-0.99. To minimize cognitive and neuromuscular fatigue, the experimental sessions will be separated by a minimum of three days (72 hours).
Somatosensory-evoked Potential
SSEP is a reliable, reproducible, and frequently employed to detect alterations in electrophysiological conduction within the central and peripheral nervous pathways. The assessment of SSEP will involve the placement of electrodes for tibial nerve stimulation at the ankle, which includes both stimulating and recording electrodes.
Perceived Pain
Visual analogue scale (VAS) is widely used to measure the frequency or intensity of various symptoms. VAS is valid, reliable, and frequently used outcome measure to measure intensity of perceived pain. Electronic-based VAS will be used to measure the level of perceived pain after the application of different cuff widths, where there will be a 10-cm/100-mm long horizontal line, with "No pain" to be rated as 0 mm, while "Worst imaginable pain" to be rated as 100 mm and the participant is asked to draw a vertical mark on the horizontal line indicating their level of perceived pain.
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