1. Introduction
Ischemic preconditioning (IPC), a procedure originally developed for the management of cardiovascular diseases, has been recognized for its potential in conditioning the heart against ischemic events. As one of the leading causes of global pathology, cardiovascular diseases, including acute myocardial infarction, present a sudden and often unanticipated challenge to heart health. The application of IPC as a preventive measure in these scenarios is well established. IPC, initially a medical procedure predominantly utilized in the treatment of cardiovascular diseases, has been successfully adapted to the realm of sports training as a conditioning method. It has become one of the pre-exercise conditioning activities (CAs) highly esteemed by coaches and trainers. As a non-invasive bio-regulatory technique, IPC serves as an intervention aimed at enhancing athletic performance without the need for invasive procedures. The intervention typically involves the application of brief occlusive pressure to the body’s muscles or tissue organs using inflatable cuffs. This brief ischemia is intended to stimulate the activation and spontaneous protective effect of organs and tissues through the phenomenon of reperfusion following the release of pressure [
1]. Consequently, it aims to improve the athletic capabilities and muscle functions of the subjects in subsequent training or competitive events, including, but not limited to, explosive power, muscular endurance, and neuromuscular adaptation [
2,
3,
4].
Fan Zihan [
5] and Wang Zhou et al. [
6] have successively conducted detailed analyses of the mechanisms by which IPC intervention enhances athletic performance. The results indicate that the mechanisms by which IPC intervention improves athletic performance primarily consist of the following three aspects: (1) IPC can effectively increase the oxygenation capacity of skeletal muscle and the blood flow of capillaries, significantly enhancing the muscle’s ability to utilize oxygen, and also markedly promoting mitochondrial biogenesis; (2) IPC can enhance the capacity for neural information transmission, thereby inducing a high degree of neuromuscular adaptation and increasing the level of muscle activation; (3) IPC can significantly increase the accumulation of a large number of endogenous nutrients, such as nitric oxide, opioid peptides, bradykinin, and adenosine secretion. These mechanisms interact with each other and collectively improve the muscle’s explosive power, endurance, and neuromuscular coordination, thereby enabling subjects to exhibit superior athletic performance in subsequent high-intensity training or competitive events. Currently, numerous scholars have explored the role of IPC in sports training from a methodological perspective, including aspects such as the site of occlusive intervention, the magnitude of occlusive pressure, the duration of IPC application, the cycling period of IPC, the differential effects of IPC usage, and its impact on athletic performance [
7,
8,
9,
10,
11]. The performance-enhancing effects of IPC are primarily manifested in two areas: strength endurance and explosive power. In terms of strength endurance, studies have found that IPC intervention can significantly enhance the strength endurance performance of certain specialized athletes and fitness populations. For instance, Barbosa’s research team [
12] arranged for healthy subjects to undergo lower limb remote IPC intervention with a cycle of 3 × 5 min at 220 mmHg, and found that the duration of the exhaustive grip strength test was prolonged by 11.2%. This study indicates that IPC intervention can significantly improve muscle endurance performance in resistance training. Regarding explosive power, Patterson et al. [
13] arranged for healthy males to undergo bilateral lower limb IPC intervention with a cycle of 4 × 5 min at 220 mmHg, and observed that the peak power during the first, second, and third sprints in the bicycle final sprint test increased significantly by 2.4 ± 2.2%, 2.7%, and 3.7 ± 2.4%, respectively, showing a clear advantage over the control group. Kraus’s research team [
14] further explored the impact of different IPC intervention methods on the enhancement of explosive power. This research team employed a randomized, double-blind, and crossover experimental design, conducting a controlled trial of unilateral alternating upper limb IPC intervention and bilateral upper limb IPC intervention, with the IPC intervention cycle consistently maintained at 4 × 5 min. The study found that both intervention methods significantly improved the peak power (increased by 3.2%) and mean power (increased by 2.7%) in the Wingate test. These results further confirm the potential of IPC intervention for enhancing endurance and explosive power, indicating that it can serve as an effective conditioning activity to help competitive athletes optimize and enhance their athletic performance.
Although the current research predominantly focuses on IPC interventions with multiple cycling periods, particularly the four-cycle pattern (4 × 5 min), an economic analysis of IPC intervention models reveals that traditional four-cycle or three-cycle IPC interventions require more than half an hour. This duration significantly increases the time and energy consumption for athletes during the warm-up phase. However, the true intent of conditioning activities is to rapidly activate the athletes’ physical functions and quickly achieve an economical state of athletic performance. Therefore, exploring IPC interventions with shorter time cycles is expected to become a major focus of future research. Against this backdrop, shorter IPC intervention cycles, such as single-cycle and double-cycle, have begun to receive widespread attention from scholars. Salagas’s research team [
15] conducted an effective exploration of single-cycle IPC intervention. When it was arranged for 12 male subjects with resistance training experience to undergo single-cycle IPC intervention (occlusive pressure: 146.7 ± 15.0 mmHg, alternating pressure) in a self-controlled experiment, it was found that in subsequent bench press tests performed at 90% of 1RM for four sets of 12 s each, the IPC intervention could significantly increase the mean velocity (+9.0 ± 4.0%) and peak velocity (+7.8 ± 7.7%) during the bench press, and also significantly increase the number of repetitions (+7.6 ± 9.5%). This result not only confirms that single-cycle IPC intervention can significantly improve upper limb motor strength performance but also indicates significant improvements in strength endurance and explosive power. Another scholar [
16] conducted an experimental study on double-cycle IPC intervention and found that double-cycle IPC intervention at an occlusive pressure of 220 mmHg could significantly increase the subjects’ jumping height (9.0 ± 9.1%), suggesting that the double-cycle IPC intervention model may have a positive impact on lower limb explosive power. Nevertheless, there is currently a lack of direct comparative studies on the impact of different cycling periods of IPC intervention on athletic performance.
IPC represents a novel non-invasive strategy that has garnered attention for its potential to augment athletic performance, particularly in the context of high-intensity resistance training. The rationale for selecting bodybuilding athletes as the subject population in this investigation is multifaceted. Bodybuilding athletes are characterized by their pursuit of muscular hypertrophy and strength, which involves repetitive exposure to strenuous resistance exercises that elicit significant myocellular stress and subsequent recovery processes. This physiological milieu provides a unique opportunity to scrutinize the effects of IPC on muscle performance enhancement and recovery kinetics. The vascularity inherent in individuals with a well-developed musculature, as observed in bodybuilding athletes, is considered a critical factor in IPC efficacy. The dense capillary network facilitates the ischemic stimulus and subsequent reperfusion, which are pivotal for initiating the purported adaptive responses. Mechanistically, IPC is posited to activate a suite of endogenous protective mechanisms. The ischemic insult triggers the release of humoral mediators, such as adenosine and bradykinin, which are implicated in the modulation of vascular tone and the initiation of angiogenic processes. The ensuing reperfusion phase is characterized by a surge in blood flow, which facilitates the restoration of oxygen and nutrient delivery to the exercised muscles, thereby potentially enhancing muscle force generation and attenuating the accumulation of metabolic byproducts associated with fatigue. By focusing our investigation on bodybuilding athletes, we aim to elucidate the intricate interplay between IPC and the physiological adaptations that underpin strength and power outcomes. This approach is expected to yield insights that are not only pertinent to the bodybuilding discipline but also extrapolatable to other athletic populations engaged in resistance-based training regimens.
In summary, for specific specialized training populations, whether IPC interventions of different training cycles will lead to differences in athletic performance in the same test still needs to be clarified through further experimental research. Such comparative studies are of significant practical importance for optimizing IPC intervention protocols to meet the needs of different athletes and to enhance the efficiency of sports training.
2. Objective and Methods
2.1. Object
This study was conducted in the Physical Fitness Room at Wuhan from October to November 2023. A randomized cross-control design was paired with a self-controlled approach. Recruitment focused on students from the institution, applying strict criteria to an initial group of 30, resulting in a final study group of 10 qualified participants.
Table 1 outlines their basic information. To counteract inherent subjective bias, the true purpose of the experiment was withheld until the conclusion, with participants informed only of an aim to explore whether occlusive pressure stimulation before exercise can enhance upper limb motor performance. The decision to select male participants was to control for hormonal and physiological variations that could impact muscle activation and training outcomes, ensuring consistency in the physiological measurements.
Eligibility was based on the following: (1) at least five years of resistance training experience, (2) proficiency in bench press and being capable of performing a bench press weight at least 0.7 times their body weight and (3) no history of chronic diseases such as heart disease or hypertension that was not under control.
Exclusion criteria included the following: (1) Any history of musculoskeletal injuries of the upper limbs or chest that could affect the ability to perform bench press exercises. (2) The presence of cervical or lumbar spine diseases that could be exacerbated by performing bench press exercises. (3) The use of any substances and equipment that could affect muscle strength or performance, such as a Weightlifting Belt, Wrist Wraps and steroids or stimulants.
An exercise risk assessment was conducted, reviewing each participant’s physical activity history and administering the Physical Activity Readiness Questionnaire (PAR-Q+) to evaluate their physical condition and ensure the safety of the protocol. The exercise environment underwent a thorough assessment to meet safety standards. Participants were fully informed about the study’s aims, methodology, and potential risks before providing their informed consent. This study has obtained consent from all participants and complies with the Declaration of Helsinki. It was approved by the Ethics Committee of Zhengzhou University’s School of Basic Medical Sciences, with the reference number ZZUIRB2023-JCYXY0019.
2.2. Methods
2.2.1. Experimental Design and Process
The experimental design of this study is meticulously structured into two principal phases: the preparatory phase and the formal testing phase. Commencing three days ahead of the formal testing, the preparatory phase involves key initiatives such as subject recruitment and the meticulous collection of basic information, including age, height, weight, years of training experience and the estimated maximum bench press weight (1RM). Subsequent to this information gathering, an 1RM test is meticulously administered to each subject, ensuring the precision and safety benchmarks for the forthcoming experiments are met.
On the day of the formal test, after a standardized warm-up and pre-test assessment, subjects serve as their own controls in a series of ischemic preconditioning (IPC) interventions {T1: single cycle (1 × 5 min), T2: double cycle (2 × 5 min), and T3: triple cycle (3 × 5 min)} and a non-IPC control intervention (CON), with the sequence determined by random assignment. The IPC intervention protocol adheres strictly to the methodology established by Rodrigues et al. [
17], utilizing a uniform IPC occlusive pressure of 170 mmHg applied to the upper arm near the proximal end, with alternating intervention methods between limbs and varying only the cycle periods. A crucial enhancement to this protocol involves the integration of advanced sensor technology to monitor and record physiological responses during the IPC intervention. These sensors provide continuous, real-time data, ensuring the accuracy of the intervention and the subsequent analysis. CON receives a minimal occlusive pressure of 20 mmHg as a “sham” IPC intervention, establishing a placebo effect control group. A 48 h interval is mandated between different intervention modes to prevent cumulative effects that might skew the experimental data and to mitigate the risk of exercise-induced fatigue or injury.
Post the pre-test and following the IPC or sham IPC intervention, subjects undergo a standardized upper limb strength performance test. This test is designed in accordance with established IPC research protocols, utilizing the same testing methodology as the studies by Wilk [
18] and Valenzuela [
19]. The test involves two sets of exhaustive bench press exercises at 60% of 1RM, with a 2 min intermission between sets. Throughout the test, state-of-the-art sensors, such as the Enode pro power collection device (Simeier, Guangzhou, China), are employed to capture real-time velocity and power metrics of the barbell during the bench press, offering a precise reflection of the subjects’ upper limb strength performance under various IPC conditions. Refer to
Figure 1 for a detailed visual representation of the experimental flowchart.
2.2.2. Main Test and Observation Indicators
(1) Bench Press 1RM Test
Three days prior to the formal experiment, all participants were arranged by the testing staff of this experiment to undergo a 1RM bench press test to establish the maximum strength output of the participants in bench press training, providing an accurate load benchmark for the subsequent experimental design. The 1RM bench press test protocol adopted the same testing scheme as in previous studies [
17,
20]: Participants determined the order of the 1RM bench press test in a random and balanced manner (drawing lots) and verbally reported their estimated 1RM bench press values to the testers. All participants underwent the same standardized warm-up procedure during the test. They first performed a dynamic warm-up, with all participants walking on a treadmill at a speed of 5–6 km/h for 5 min and activating the shoulder and chest muscle groups during this process. Subsequently, participants underwent a specialized warm-up for the bench press, using loads of 20%, 40%, and 60% of the estimated 1RM, completing 15, 10, and 5 repetitions of the bench press, respectively, to adapt to the high-load 1RM bench press test that followed. Participants were required to perform the bench press with a unified standard movement: They were instructed to use a unified standard movement for the bench press to ensure the accuracy of the test. The barbell must touch the chest on the descent, and the elbows must be fully extended on the push, achieving the complete standard of the bench press movement. The testers used a metronome to control the participants’ rhythm, with the eccentric phase (Point A → Point B) lasting 2 s, and the concentric phase (Point B → Point C) being required to be completed at the fastest speed. After the specialized warm-up, participants performed stretching of the pectoralis major, deltoids, and triceps for 3 min to prevent muscle strain. The official 1RM test began at 80% of the estimated 1RM weight, gradually increasing the weight by 4–9 kg each time until the participant could not complete the specified number of repetitions. Between each weight increase, participants had a 2 min rest period. If the weight was successfully lifted in the attempt, it would continue to increase by 4–9 kg; if it failed, it would decrease by 2–4 kg. In this way, the participant’s 1RM was determined in 3–5 attempts. The 1RM of all participants in the bench press was determined in 5 experiments.
Figure 2 is an illustrative diagram of the bench press 1RM.
(2) IPC Intervention
This study adopted the upper limb IPC intervention protocol designed by the research team of Rodrigues et al. [
17]: each subject was required to use a uniform IPC occlusive pressure, intervention site, and method of intervention. The occlusive pressure was set at 170 mmHg, the intervention site was the upper arm close to the proximal end, and the intervention method was alternating between upper limbs. The experimental group varied only in the cycling period of the IPC intervention as the sole variable. In the single-cycle IPC intervention, subjects were first required to undergo 5 min of upper limb occlusive intervention to create an ischemic environment, followed by the release of occlusive pressure to promote blood reperfusion for another 5 min (starting with one arm, then alternating to the other arm for occlusion/release). The double-cycle IPC intervention, based on the single-cycle IPC intervention, repeated the cycle of pressurization and depressurization to ensure that each arm underwent two rounds of 5 min of pressurization and 5 min of depressurization and reperfusion. The triple-cycle IPC intervention required subjects to complete three rounds of 5 min of pressurization and 5 min of depressurization and reperfusion for each arm.
Figure 3 illustrates the IPC intervention;
Figure 4 displays the IPC equipment: the Theratools BFR device (Simeier, Guangzhou, Guangdong, China).
(3) Upper Limb Strength Test
The study employed an upper limb strength testing protocol consistent with previous research [
18]: all subjects performed two sets of exhaustive bench press tests at 60% of their 1RM, with a 5 min interval between each set to ensure the adequate recovery of physical strength before the next test, preventing the occurrence of exercise fatigue that could affect the test results. The requirements for the bench press movement in the upper limb strength test were kept consistent with the 1RM test, with the only change being the speed of the bench press, which was modified to be pushed up as quickly as possible with individual maximum explosive power, meaning that both the eccentric and concentric phases of each repetition of the bench press were performed at the maximum possible speed, with exhaustion defined as the inability to complete the bench press with the standard movement. The Enode pro (Germany), a sports performance power data collection device, was used to record the time under tension (TUT), peak power output (PP), mean power output (MP), peak velocity (PV), and mean velocity (MV) of each set of bench presses during the test for subsequent data analysis.
Figure 5 illustrates the power curve recorded during the upper limb strength test using the Enode pro;
Figure 6 displays the Enode pro device. The Enode pro sensor was selected for its high precision and reliability, providing continuous and real-time data that ensure the accuracy of the intervention and the subsequent analysis. Through these measurements, we were able to conduct a detailed analysis of the effects of IPC intervention on muscle activation and athletic performance, which is crucial for understanding the role of IPC in enhancing the effectiveness of sports training [
21].
(4) Experimental Control
In the present study, due to the use of a within-subjects experimental design, it is essential to exert strict control over potential confounding factors in the experimental process to ensure the accuracy and reliability of the results. The specific control measures are as follows: ① To monitor the changes in the upper limb strength performance of the subjects throughout the experimental testing period, although this study is an acute experiment, considering the four tests conducted by random drawing, subjects were required to avoid any specialized training related to bodybuilding during the experimental period. This included, but was not limited to, high-intensity resistance training, aerobic exercise, and physical fitness training. This measure is intended to prevent muscle damage and exercise fatigue caused by high-load resistance training, as well as to prevent exercise injuries that could lead to subjects withdrawing from the experiment. Additionally, this helps to avoid the “dynamic increase effect” of strength during the experiment, ensuring the accuracy of the 1RM data. ② The experiment was conducted in two stages: the bench press 1RM test and the formal test, with a 3-day interval between the two. This arrangement is to mitigate the exercise fatigue and potential exercise injuries that the maximum load 1RM test might cause, ensuring that the subjects are in the best physical condition during the formal test. ③ Throughout the experimental phase, subjects were required to strictly control their diet and daily routine to regulate their circadian rhythm. At the same time, the daily living habits of all subjects should be as consistent as possible to reduce interference from external factors. This includes a balanced diet, adequate hydration, sufficient and quality sleep, and other lifestyle habits that could affect the test results.
2.3. Statistical Analysis
After the completion of the experiment, the collected data were entered into Excel V2.5.294.2024 for the systematic categorization of all raw data, and the means and standard deviations were recorded. SPSS 25.0 was utilized for differential analysis, employing a repeated measures analysis of variance for the pre-experimental and post-experimental strength performance indicators within groups, and a one-way analysis of variance for the post-experimental strength performance indicators between groups. This analysis was conducted to assess the differences in the impact of IPC intervention with different cycling periods on the upper limb strength performance of college male bodybuilding athletes. In the testing process, a p-value of less than 0.05 indicates a level of significant difference, while a p-value of less than 0.01 indicates a level of highly significant difference.