Applicability of Tissue Flossing for Blood Flow Restriction in the Upper Limb: Reliability and Performance Analysis

NCT ID: NCT06512961

Last Updated: 2026-02-13

Basic Information

• Recruitment Status: ENROLLING_BY_INVITATION
• Clinical Phase: NA
• Total Enrollment: 34 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-08-01
• Study Completion Date: 2026-07-15

Brief Summary

Blood flow restriction (BFR) is a widely studied technique that combines low-intensity exercise with vascular occlusion, resulting in muscular benefits. However, its application is challenging due to methodological variations and equipment costs. Tissue Flossing (TF) appears as an affordable alternative, but lacks solid scientific evidence.

Detailed Description

Objectives: to evaluate the intra- and inter-rater reliability of the occlusion pressure generated by TF, investigate the reproducibility of TF application on different days and compare TF with traditional RFS in terms of muscle gains.

Methods: the study is divided into two stages: First stage, randomized controlled crossover clinical trial, 80 healthy individuals aged 18 to 30 years old evaluated to determine the reliability of the TF. Participants will follow one of two types of randomization, with exclusions based on health criteria. Assessments include anthropometric characteristics, determination of occlusion pressure (POT), identification of 40% and 80% of POT, flow data and arterial diameter after TF application. Statistical analysis will use the intraclass correlation index (ICC) and specific models for intra- and inter-rater analyses. Second stage, randomized controlled clinical trial with parallel groups, 34 participants will be evaluated over fifteen weeks. The initial procedures involve anthropometric assessments, POT determination, myotonometry, ultrasound, perceptual scale and 1RM test, applied to both upper limbs. Participants will perform a upper limb training protocol using RFS or TF, following myotonometric and perceptual assessments. After training, final assessments will measure the same parameters initially assessed. Statistical analysis will use normality tests, Generalized Mixed Models and effect size analysis in SPSS software, with a significance level of p<0.05. Expected results: This study is expected to provide information on the reliability and reproducibility of TF in generating occlusion pressure. Furthermore, the investigatorsF seek to validate TF by comparing it with traditional RFS in terms of muscle gains. If effective, TF could become an affordable option to promote muscle gains, in different application scenarios.

Participants will be duly informed about the procedures and objectives of this study, and after agreeing, they will sign an informed consent form, effectively becoming part of it. In the consent form, participants will be asked if they agree to the use of their data if they choose to withdraw from the study. Participants will also be asked for permission for the research team to share relevant data with people at universities participating in the research or regulatory authorities, where relevant. The study were approved to the Research Ethics Committee of FCT/UNESP, Presidente Prudente, SP, Brazil.

Conditions

Hypertrophy; Muscle Strength

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: SINGLE

Study Groups

Group Traditional BFR

This group will perform the training protocol with traditional BFR, using a pressure cuff as an occluder on both arms.

Group Type: ACTIVE_COMPARATOR

Blood Flow Restriction Cuff

Intervention Type: DEVICE

Inflatable device that exerts an external pressure above a muscle or joint of the extremities.

Training Protocol

Intervention Type: OTHER

The upper limb resistance training protocol will follow that recommended in the study by Patterson et al. for resistance training, and will last 15weeks, with 3 training sessions per week, with a day break between sessions.

Group BFR TF

This group will perform the training protocol with BFR using TF on both arms.

Group Type: EXPERIMENTAL

Tissue Flossing

Intervention Type: DEVICE

Tissue Flossing ia a elastic band that when applied exerts an external pressure above or below a muscle or joint of the extremities.

Training Protocol

Intervention Type: OTHER

The upper limb resistance training protocol will follow that recommended in the study by Patterson et al. for resistance training, and will last 15weeks, with 3 training sessions per week, with a day break between sessions.

Interventions

Tissue Flossing

Tissue Flossing ia a elastic band that when applied exerts an external pressure above or below a muscle or joint of the extremities.

Intervention Type: DEVICE

Blood Flow Restriction Cuff

Inflatable device that exerts an external pressure above a muscle or joint of the extremities.

Intervention Type: DEVICE

Training Protocol

The upper limb resistance training protocol will follow that recommended in the study by Patterson et al. for resistance training, and will last 15weeks, with 3 training sessions per week, with a day break between sessions.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Individuals who present one or more of the following characteristics will not be included:
• 1 presence of any health condition that contraindicates or prevents exercise;
• 2 diabetes and diagnosed high blood pressure;
• 3 inflammatory, psychiatric, cardiovascular and/or respiratory rheumatological disease; - -4 being dependent on alcohol, consuming drugs and/or being a smoker;
• 5 history of knee surgery (e.g., meniscal repair and ligament reconstruction) or recent upper limb musculoskeletal injury that may impair performance during tests or interventions (e.g., muscle injury, tendinopathy, patellofemoral pain and/or back pain column in the last six months);
• 6 use of ergogenic supplements to improve physical performance and/or muscle mass and/or vasoactive medications;
• 7 having one or more risk factors predisposing to thromboembolism

Exclusion Criteria

• Participants will be excluded from the study if they:
• 1 have a health problem that does not allow them to continue;
• 2 wish to leave the study;
• 3 not sign the consent form

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 30 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: Yes

Sponsors

Coordination for the Improvement of Higher Education Personnel

OTHER

Sponsor Role: collaborator

Paulista University

OTHER

Sponsor Role: lead

Responsible Party

Franciele Marques Vanderle

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

UNESP

Presidente Prudente, São Paulo, Brazil

Countries

Brazil

Other Identifiers

78229724.9.0000.5402

Identifier Type: -

Identifier Source: org_study_id