Investigating the influence of limb blood flow on contraction-induced muscle growth and the impact of that growth on changes in maximal strength

Changes in skeletal muscle size may be affected by resting blood flow (e.g., nutrient delivery), and this change in size is a hypothesized mechanism for changes in strength. Purpose To determine 1) whether the relationship between isometric training and muscle growth depends on baseline blood flow or is mediated by a change in blood flow, and 2) whether muscle growth mediates changes in maximal isometric strength. Methods A total of 179 participants were randomized into low-intensity isometric handgrip exercise (LI), low-intensity isometric handgrip exercise with blood flow restriction (LI-BFR), maximal handgrip exercise (MAX), and a non-exercise control (CONTROL). Muscle thickness, strength, and resting limb blood flow were measured before and after the 6-wk intervention. Results Baseline blood flow did not moderate training effects on muscle thickness changes (MTHchg) (P = 0.666), and moderated mediation tests were nonsignificant. Although the LI-BFR group showed a significant effect on MTHchg (P = 0.018), MTHchg was not significantly related to handgrip strength change (HGchg) (P = 0.281), suggesting no mediation of the training-to-strength effect by MTHchg. Both the LI-BFR (P = 0.004) and MAX (P < 0.001) groups exhibited positive direct effects on HGchg compared with CONTROL. Furthermore, there were no differences between training groups and CONTROL on blood flow change (BFchg), BFchg and MTHchg were not significantly related, and neither BFchg nor MTHchg predicted HGchg, providing no evidence for mediated pathways. Conclusions Muscle growth may not have occurred to an extent that would require vascular adaptation. Training maximally induced the greatest strength adaptations but was seemingly not driven by muscle growth.