Translational perspectives on neurophysiological responses and mechanisms in blood flow restriction exercise

Maintaining corticospinal tract function is crucial for voluntary movement. Exercise using high external loads/intensities is a promising intervention to promote adaptations to the corticospinal tract and improve physical function; however, such loads/intensities may not be tolerable or safe in populations with neurological disorders, motor-impaired injuries and older adults. Exercise using low external loads/intensities with blood flow restriction offers an alternative that provides comparable adaptations in muscular hypertrophy, strength and function (e.g., gait performance) to higher external-load/intensity exercise. Although some data suggest that blood flow restriction exercise may induce neuroplasticity, the neurophysiological responses remain largely unknown. Given the potential significance of blood flow restriction exercise for clinical populations, this review synthesises available data and potential mechanisms of these neuroplastic responses while providing translational insights and future research recommendations.