Cross-Education Responses to Unilateral Blood Flow Restriction Walking Exercise

Abstract

<title>Abstract</title> <p>Background The aim of this study was to investigate whether unilateral blood flow restriction (BFR) training can promote strength development in both the directly trained and untrained limbs through the cross-education effect. Methods Thirty-three male volunteer athletes participated in the study; three were excluded due to brachial index values outside the required range, leaving 30 participants (age = 19.53 ± 1.79 years; body mass = 70.84 ± 9.76 kg; height = 177.23 ± 5.17 cm; brachial index = 0.97 ± 0.08). The vascular restriction level, determined using the tibialis posterior artery, was monitored via Doppler device. Walking exercise was performed with 40% arterial occlusion pressure (AOP) applied to the dominant leg for six sessions at 48-hour intervals. Countermovement jump (CMJ) measurements were collected for the dominant, non-dominant, and bilateral legs immediately after each session. Data were analyzed using JASP software (v0.19.3) with significance set at p ≤ 0.05. Results Friedman analysis showed significant changes in dominant leg performance over time (TFLight (s): χ²(6) = 77.25, p ≤ .001, Kendall’s W = .429; Height (cm): χ²(6) = 105.67, p ≤ .001, Kendall’s W = .587; Jump Point: χ²(6) = 18.52, p = .005; Used Area: χ²(6) = 19.32, p = .004). In the non-dominant leg, significant differences were found for TFLight (χ²(6) = 62.76, p ≤ .001, Kendall’s W = .349) and Height (χ²(6) = 62.97, p ≤ .001, Kendall’s W = .350). No significant differences were observed for Jump Point, Used Area, and Verticality variables (p &gt; 0.05). Conclusions Unilateral low-pressure BFR walking exercise induced significant improvements in both the BFR-applied (dominant) leg and the non-applied (non-dominant) leg, as well as in bilateral jump performance. These findings support the use of BFR as an effective method to facilitate the cross-education effect, even with low-pressure protocols.</p>