Date of Award


Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy in Integrative Physiology (PhD)

Administrative Home Department

Department of Kinesiology and Integrative Physiology

Advisor 1

Steven Elmer

Committee Member 1

Tejin Yoon

Committee Member 2

Min Wang

Committee Member 3

John McDaniel


Exercise with blood flow restriction (BFR) allows healthy, clinical, and athletic populations to improve their strength and exercise capacity. The main advantages exercise with BFR has over traditional training are: 1) increases in muscle size, strength, and exercise capacity are elicited at low training loads, 2) these adaptations occur faster with blood flow restriction, 3) increases in muscle size and strength can be stimulated during both resistance and aerobic exercise. Currently, there are no standardized guidelines for exercise with BFR. I used a variety of experimental techniques including ultrasound, near-infrared spectroscopy, expired air analysis, electrical stimulation, and dual-energy X-ray absorptiometry to investigate how cuff pressure and as well as the type of exercise alter acute and chronic responses to exercise with BFR. I was the first to report changes in blood flow during resistance exercise with BFR, and before and after aerobic exercise with BFR. Additionally, I am the first to directly report differences in muscle size, strength, and exercise capacity following aerobic or resistance training with BFR. Overall, I found that the relative reduction in blood flow measured prior to exercise is maintained during exercise. Additionally, I found that moderate cuff pressures of ~60% of limb occlusion pressure increase metabolic stress without completely occluding blood flow, and therefore is an adequate pressure for both aerobic and resistance exercise with BFR. Finally, I found that aerobic exercise with BFR may be more favorable than resistance exercise because it results in similar increases in muscle size and strength, but at a lower ratings of perceived effort and pain. Taken together, these studies will enable researchers, clinicians, and coaches to more effectively prescribe exercise with BFR to improve muscle size, strength and exercise capacity.