Low-intensity aerobic training with blood flow restriction versus high-intensity aerobic interval training on anaerobic parameters in untrained individuals: quasi-experimental study

Primary objective: To compare the effects of Low-intensity aerobic training with blood flow restriction on anaerobic power and capacity versus High-intensity aerobic interval training in untrained individuals.

Secondary objective: To compare the effects of Low-intensity aerobic training with blood flow restriction versus high-intensity aerobic interval training on muscle endurance and power in untrained individuals.

Justification for study: 1. This research will provide a clear, descriptive reference to design a Blood Flow Restriction aerobic training program for an untrained individual.

2. The time-efficiency, load-efficient, and lesser exertion effects of Blood Flow Restriction Training will help untrained individuals perform consistent exercise.

3. There are limited studies on studying the effects of Blood Flow Restriction Training on anaerobic capacity and muscle endurance in untrained populations, and no studies compare the effects of walk training with Blood Flow Restriction and traditional High-Intensity Interval Training.

After IEC and IRC approval, CTRI registration and approval will be obtained. All the participants will undergo these tests before and after the intervention/exercise program to obtain the baseline and post-intervention test results, respectively. The tests will be performed: 1. Wingate Anaerobic Test  2. Squat Test  3. Standing Vertical Jump Test

The participant recruitment process begins with screening and assessing the participants for their eligibility, after excluding the participants who do not match the inclusion criteria, denied participation, or denied providing consent of participation. Depending on their convenience, the participants will be divided into Low-Intensity aerobic training with a BFR group (LI-BFR) or a High-Intensity aerobic interval training group (HIIT). Both groups are equally divided into the required sample size. The familiarization of the tests will be performed for all the participants. The participants of the LI-BFR group are familiar with BFR cuffs, and occlusion pressure is determined using the VALD Digital Air Band (BFR Cuffs). These cuffs will be tied on the proximal-most part of the lower limb and inflated to record the resting Blood pressure of the limb in the supine position. The baseline/ pre-testing will be performed after 48 hours of familiarization. The intervention for both groups will begin after 48 hours of pre-testing. In the LI-BFR group, the participants will perform ground walking with BFR cuffs inflated for 60% leg occlusion pressure (LOP) for 15 minutes. This will be continuous, comfortable pace walking, which will be supervised throughout to maintain the RPE at 6-8.

In the HIIT group, the participants will perform a set of exercises for 3 sets, each exercise lasting 30 seconds with as many repetitions as possible. After each exercise, 5 seconds and after each set, 30 seconds of rest will be incorporated. This protocol will be supervised throughout to alter the RPE between 12-18. Standardized warmup and cooldown exercises will be demonstrated and applied. The exercises include Jumping Jacks, Burpees, Mountain climbers, Inchworm Air squats, and High Knees.

The intervention will continue for 6 weeks, 4 sessions/week (24 sessions). The intervention session will last up to 15 minutes. After 48 hours of intervention completion, the post-testing will be performed. As the participants are untrained, the intervention will be supervised, and proper care will be taken of the participants. Since the exercise intervention is supervised, there is a minimal risk of injury occurring. If there is any injury, the student researcher is well-equipped to manage the acute injury. Participants are prone to muscle cramps, muscle aches/muscle soreness,/Delayed Onset of Muscle Soreness. The participants will be advised to use a hot water bag application after every session to minimize the effect of muscle soreness. As PI is a healthcare provider, immediate care will be provided to the participants who experience discomfort during the session. An optimal amount of muscle spray(diclofenac) and a first aid kit will be available if necessary.

The participants will receive a baseline report on their health/physical parameters like anaerobic capacity, muscle endurance, and power. These metrics can help them understand the necessity of performing the exercise and motivate them to be consistent in it. The participants will get a well-planned, supervised exercise routine for 6 weeks, which they can further pursue on their own. They can benefit from supervised physical activity and exercise during the intervention, which helps them learn proper form and posture. The exercise program and post-intervention test will help them understand how the intervention/exercise program has helped them to improve their health. Even during the intervention of 6 weeks, the participants can experience the effects of regular exercise, which motivates them to be consistent.