In the past, we have presented the effect of BFR vs. conventional high-load training, but for practical applications, BFR is often more applicable as an add-on on.

This has been explored in a recent RCT from University of southern Denmark and in a practical research-based guide from Rolnick & Schoenfeld.

In the RCT, the researchers compared the effect of lower-limb block-structured training, consisting of alternating weeks of BFR training and conventional Heavy-Load resistance training (BFR+HL) vs. only (HL).

Methods: 18 active young participants were randomized to either 6-weeks (22 sessions) of structured training alternating weekly between BFR (20% 1RM) + HL (70-90% 1RM) vs. only HL (70-90% 1RM).

Outcomes: Maximal isometric knee extensor strength (MVC) and muscle biopsies (VL) as myofiber cross-sectional area (CSA), myonuclear (MN) number and satellite cell (SC) content.

Results: MVC increased in both groups (BFR+HL: +12%) vs. (HL: +7%). Type 2 CSA increased similarly in both groups (16%), while gains in type 1 CSA were only observed in HL (12%).

Conclusion: Conventional HL can periodically be replaced by low-load BFR without compromising gains in maximal muscle strength.

In the practical research-based guide, you will find an evidence-based recommendation on how to maximize hypertrophic potential with the implementation of BFR into a conventional program.

From the comprehensive amount of original research on this topic, it seems legit to add 1–2 exercises per target muscle group at the end of a heavy-load training session, to preferentially stress type 1 muscle fibers as a “finisher”.

This perspective on muscle fiber differentiation seems valid as the authors have discovered this from at least 2 original research articles, but this is actually the direct opposite trend that was discovered in the RCT!

Any thoughts or explanation, as why the RCT found that only the conventional High Load group gained type 1 muscle fiber hypertrophy?

Secondly, what should be considered when choosing to either implement BFR as alternatingly weeks/days (the RCT) vs. supplement to conventional training as a finisher?

Source:

Hansen et al. (2020) Effects of alternating blood-flow restricted training and heavy-load resistance training on myofiber morphology and mechanical muscle function.

Rolnick et Schoenfeld (2020) Blood Flow Restriction Training and the Physique Athlete- A Practical Research-Based Guide to Maximizing Muscle Size.