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.