Multiple Exposures to Blood Flow Restriction Walking Affects Ratings of Perceived Exertion but Not Pain Direct Original Research
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Keywords
Aerobic Exercise, Exercise Tolerance, Exercise Familiarization
Abstract
Introduction: Blood flow restriction (BFR) walking elicits improved fitness, but participants often report higher ratings of perceived exertion (RPE) and pain during BFR walking compared to non-BFR walking. The primary aim was to investigate how multiple BFR walking exposures might affect RPE and pain.
Methods: 14 healthy, trained participants completed three BFR walking sessions on separate days. The treadmill speed that elicited 3/10 RPE while BFR was not applied was determined and that same speed was used during all BFR walking sessions. Participants walked for 15 minutes at the predetermined speed while 60% limb occlusion pressure was applied bilaterally to the thighs. RPE (0-10) and pain (0-10) were recorded during each minute of exercise. Two-way repeated measures analysis of variance determined if session (1-3) and/or time (1-15 minutes) affected RPE or pain. Statistical significance was established at p<0.05.
Results: RPE was higher during session 1 compared to session 2 (minutes 8-15, 4.4±1.4 versus 3.6±0.8). RPE was higher during session 1 compared to session 3 (minutes 3-5, 3.5±0.7 versus 2.9±0.6; minutes 7-15, 4.3±1.3 versus 3.5±1.1). No significant differences were observed for pain.
Conclusion: Participants might tolerate BFR walking better after completing two BFR walking sessions as lowered RPE responses were observed.
References
2. Abe T, Sakamaki M, Fujita S, et al. Effects of low-intensity walk training with restricted leg blood flow on muscle strength and aerobic capacity in older adults. Journal of Geriatric Physical Therapy. 2010;33(1):34-40.
3. Abe T, Kearns CF, Sato Y. Muscle size and strength are increased following walk training with restricted venous blood flow from the leg muscle, Kaatsu-walk training. Journal of Applied Physiology. 2006;100(5):1460-1466.
4. Ozaki H, Miyachi M, Nakajima T, Abe T. Effects of 10 weeks walk training with leg blood flow reduction on carotid arterial compliance and muscle size in the elderly adults. Angiology. 2011;62(1):81-86.
5. Sakamaki M, G. Bemben M, Abe T. Legs and trunk muscle hypertrophy following walk training with restricted leg muscle blood flow. J Sports Sci Med. 2011;10(2):338-340.
6. Silva JCG, Domingos-Gomes JR, Freitas EDS, et al. Physiological and perceptual responses to aerobic exercise with and without blood flow restriction. J Strength Cond Res. 2021;35(9):2479-2485.
7. Mok E, Suga T, Sugimoto T, et al. Negative effects of blood flow restriction on perceptual responses to walking in healthy young adults: A pilot study. Heliyon. 2020;6:e04745.
8. Cayot T, Markwardt S, Fisher H, et al. A single bout of continuous blood flow restriction walking does not negatively affect lower limb microvascular function. Research In Health And Medicine. 2026;6(1):3.
9. Cayot T, Bellew JW, Zapata-Rodriguez E, et al. Effects of neuromuscular electrical stimulation waveforms and occlusion pressures on elicited force and microvascular oxygenation. Journal of Sport Rehabilitation. 2024;34(5):484-491.
10. Hughes L, Jeffries O, Waldron M, et al. Influence and reliability of lower-limb arterial occlusion pressure at different body positions. PeerJ. 2018;6:e4697.
11. Ozemek C, Bonikowske A, Christle J, Gallo P. ACSM’s Guidelines for Exercise Testing and Prescription. 12th ed. Wolters Kluwer; 2026.
12. Bellew JW, Cayot T, Brown K, et al. Changes in microvascular oxygenation and total hemoglobin concentration of the vastus lateralis during neuromuscular electrical stimulation (NMES). Physiother Theory Pract. 2021;37(8):926-934.
13. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods. 2007;39(2):175-191.
14. Stevens CJ, Gillman AS, Giordano GR, Bryan AD. Modeling longitudinal variation in affective response to exercise across a 16-week randomized control trial (RCT). Health Psychology. 2021;40(12):928-939.
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Copyright, 2026 by the authors. This work is licensed under the Creative Commons Attribution 4.0 International License.