Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training

Abstract Background It is recommended to prescribe sets to volitional muscular failure (e.g., 4 sets) or a fixed repetition scheme of 75 repetitions (1 × 30, 3 × 15) in low-load resistance exercise with blood flow restriction (BFR-RE). While prior studies suggest both protocols may elicit similar mu...

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Main Authors: Nicholas Rolnick, Victor S. de Queiros, Ethan C. Hill, Thomas Bjørnsen, Tim Werner, Jeremy P. Loenneke
Format: Article
Language:English
Published: SpringerOpen 2025-07-01
Series:Sports Medicine - Open
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Online Access:https://doi.org/10.1186/s40798-025-00892-z
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author Nicholas Rolnick
Victor S. de Queiros
Ethan C. Hill
Thomas Bjørnsen
Tim Werner
Jeremy P. Loenneke
author_facet Nicholas Rolnick
Victor S. de Queiros
Ethan C. Hill
Thomas Bjørnsen
Tim Werner
Jeremy P. Loenneke
author_sort Nicholas Rolnick
collection DOAJ
description Abstract Background It is recommended to prescribe sets to volitional muscular failure (e.g., 4 sets) or a fixed repetition scheme of 75 repetitions (1 × 30, 3 × 15) in low-load resistance exercise with blood flow restriction (BFR-RE). While prior studies suggest both protocols may elicit similar muscular adaptations, the extent to which this is explained by matched exercise volume remains unclear. Objectives This systematic review and meta-analysis evaluated the number of repetitions performed during four sets of low-load BFR-RE to volitional muscular failure and compared these with the fixed 75-repetition scheme. The goal was to determine whether the two protocols yield similar total and per-set repetition volumes. Methods On 10/31/2024, two databases (PubMed® and Scopus) were used to identify studies that applied a protocol of four sets to volitional muscular failure in BFR-RE with a load of ≤ 50% of one repetition maximum (1RM), regardless of the outcome investigated. Mean repetition data were pooled using a random-effects meta-analysis. One-sample t-tests compared per-set and total volumes to the reference scheme (1 × 30, 3 × 15). Results Across 25 studies (47 means; n = 678), the estimated total repetitions performed to failure was 73.1 (95% CI: 61.1 to 85.2). Per-set means were 36.0 (95% CI: 30.5 to 41.4), 14.7 (95% CI: 12.2 to 17.1), 11.5 (95% CI: 9.2 to 13.8), and 10.4 repetitions (95% CI: 8.1 to 12.7) for sets 1 through 4, respectively. Conclusion Four sets of BFR-RE to volitional muscular failure produce similar total repetition volume compared to the commonly implemented fixed 75-repetition scheme, though the distribution of repetitions per set differs. These findings provide insight into the mechanical equivalence of two widely used BFR-RE prescriptions.
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spelling doaj-art-c5a99bd1c3d84dd0b10e5d525bddb1212025-08-20T03:46:04ZengSpringerOpenSports Medicine - Open2198-97612025-07-0111111510.1186/s40798-025-00892-zDoes Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance TrainingNicholas Rolnick0Victor S. de Queiros1Ethan C. Hill2Thomas Bjørnsen3Tim Werner4Jeremy P. Loenneke5Department of Exercise Science and Recreation, CUNY Lehman CollegeDepartment of Physical Education, State University of Paraíba [UEPB]School of Kinesiology and Rehabilitation Sciences, University of Central FloridaDepartment of Education and Sport Science, University of StavangerExercise Science, Salisbury UniversityKevser Ermin Applied Physiology Laboratory, The University of MississippiAbstract Background It is recommended to prescribe sets to volitional muscular failure (e.g., 4 sets) or a fixed repetition scheme of 75 repetitions (1 × 30, 3 × 15) in low-load resistance exercise with blood flow restriction (BFR-RE). While prior studies suggest both protocols may elicit similar muscular adaptations, the extent to which this is explained by matched exercise volume remains unclear. Objectives This systematic review and meta-analysis evaluated the number of repetitions performed during four sets of low-load BFR-RE to volitional muscular failure and compared these with the fixed 75-repetition scheme. The goal was to determine whether the two protocols yield similar total and per-set repetition volumes. Methods On 10/31/2024, two databases (PubMed® and Scopus) were used to identify studies that applied a protocol of four sets to volitional muscular failure in BFR-RE with a load of ≤ 50% of one repetition maximum (1RM), regardless of the outcome investigated. Mean repetition data were pooled using a random-effects meta-analysis. One-sample t-tests compared per-set and total volumes to the reference scheme (1 × 30, 3 × 15). Results Across 25 studies (47 means; n = 678), the estimated total repetitions performed to failure was 73.1 (95% CI: 61.1 to 85.2). Per-set means were 36.0 (95% CI: 30.5 to 41.4), 14.7 (95% CI: 12.2 to 17.1), 11.5 (95% CI: 9.2 to 13.8), and 10.4 repetitions (95% CI: 8.1 to 12.7) for sets 1 through 4, respectively. Conclusion Four sets of BFR-RE to volitional muscular failure produce similar total repetition volume compared to the commonly implemented fixed 75-repetition scheme, though the distribution of repetitions per set differs. These findings provide insight into the mechanical equivalence of two widely used BFR-RE prescriptions.https://doi.org/10.1186/s40798-025-00892-z75 RepetitionsFixed ProtocolBFR TrainingLimb Occlusion PressureResistance Exercise
spellingShingle Nicholas Rolnick
Victor S. de Queiros
Ethan C. Hill
Thomas Bjørnsen
Tim Werner
Jeremy P. Loenneke
Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
Sports Medicine - Open
75 Repetitions
Fixed Protocol
BFR Training
Limb Occlusion Pressure
Resistance Exercise
title Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
title_full Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
title_fullStr Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
title_full_unstemmed Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
title_short Does Protocol Matter for Repetition Volume? A Meta-Analytic Investigation of Volitional Failure Versus the Traditionally Used 75-Repetition Blood Flow Restriction Resistance Training
title_sort does protocol matter for repetition volume a meta analytic investigation of volitional failure versus the traditionally used 75 repetition blood flow restriction resistance training
topic 75 Repetitions
Fixed Protocol
BFR Training
Limb Occlusion Pressure
Resistance Exercise
url https://doi.org/10.1186/s40798-025-00892-z
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