Despite the lack of scientific evidence, the effects of tissue flossing have been identified as having similar effects of BFR \cite{Driller_2017}. In contrast to the findings of the present study, where limb wrapping induced neuromuscular potentiation (increased knee extensors MVC and faster RF muscle contraction time), studies investigating the acute effects of BFR on neuromuscular parameters showed significant muscle fatigue \cite{HUSMANN_2018,Girard_2019,Karabulut_2010,Yasuda2008}. The observed discrepancies between the present study and those BFR studies may be associated with differences in intervention protocols. The active knee extension-flexion protocol without additional load adopted in the present study is similar to the protocols used in other tissue flossing studies \cite{Driller_2017a,Mills_2020}. In contrast, studies investigating the acute effects of BFR adopted protocols with several sets using additional load, ranging from 20% \cite{Yasuda2008} up to 70% 1RM \cite{Girard_2019} to (or near to) volitional muscle failure. \cite{Karabulut_2010} observed drops in MVC, level of voluntary activation, potentiated single twitch and EMG amplitude after a fatiguing protocol using BFR.
Similarly, \citet{HUSMANN_2018} reported a substantial drop in neuromuscular performance during a fatiguing protocol using BFR. However, all the measured parameters recovered to near baseline levels within 2 minutes after cuff removal. Tissue reperfusion has been proposed as the primary mechanism for neuromuscular parameter recovery in BFR studies \cite{HUSMANN_2018,COOK_2007}.
According to studies where the acute effects of BFR on neuromuscular performance were investigated, the observed fatigue seems to be affected by wrapping pressure, where it has been suggested that higher pressures can induce considerable change in neuromuscular parameters \cite{Fatela_2016,Yasuda2008}\citet{Yasuda2008} investigated the acute effects of BFR on MVC and EMG amplitude using different degrees of wrapping pressure. The authors observed a pressure-sensitive decrease in MVC immediately following BFR intervention and an increase in EMG during the fatiguing protocol (higher pressures resulting in more significant parameter shift). However, 1 minute after cuff removal, MVC and EMG recovered to baseline levels. Similarly, \citet{Fatela_2016} indicated that neuromuscular fatigue, as well as muscle activation, are pressure-sensitive and vary as a function of relative vascular occlusion. In contrast, \citet{Girard_2019} were unable to find any significant difference between local (BFR) and systemic hypoxic stimuli, or a combination of both, on neuromuscular performance, regardless of the degree of wrapping pressure. Compared to the findings identified in the previously mentioned BFR studies, in the present study, only the LOW condition induced feasible evidence of neuromuscular potentiation, suggesting that individualized pressure should be used in order for neuromuscular potentiation to take place.