Acute Effects of Continuous and Intermittent Blood Flow Restriction on Movement Velocity During Bench Press Exercise Against Different Loads

Effects of Blood flow Restriction and Load on Mean Propulsive Velocity and Subjective Perceived Exertion During Squat and Bench Press Exercises

BACKGROUND

The aim of this study was to determine the influence of different percentages of blood flow restriction (BFR) and loads on mean propulsive velocity (MPV) and subjective perceived exertion during squat (SQ) and bench press (BP) exercises.

HYPOTHESIS

Higher percentages of BFR will positively affect dependent variables, increasing MPV and reducing perceived exertion.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Eight healthy young male athletes took part. Two sets of 6 repetitions at 70% 1-repetition maximum (1RM), 2 sets of 4 repetitions at 80% 1RM, and 2 sets of 2 repetitions at 90% 1RM were performed randomly; 5-minute recoveries were applied in all sets. The varying arterial occlusion pressure (AOP) applied randomly was 0% (Control [CON]), 80%, and 100%.

RESULTS

No statistically significant differences in MPV were found during the BP exercise at any percentage of BFR at any percentage 1RM. During the SQ exercise, MPV results showed statistically significant increases of 5.46% (P = 0.04; ηp2 = 0.31) between CON and 100% AOP at 90% 1RM. The perceived exertion results for the BP exercise showed statistically significant reductions of -8.66% (P < 0.01; ηp2 = 0.06) between CON and 100% AOP at 90% 1RM. During the SQ exercise, the perceived exertion results showed significant reductions of -10.04% (P = 0.04; ηp2 = 0.40) between CON and 100% AOP at 80% 1RM; -5.47% (P = 0.02; ηp2 = 0.48) between CON and 80% AOP at 90% 1RM; and -11.83% (P < 0.01; ηp2 = 0.66) between CON and 100% AOP at 90% 1RM.

CONCLUSION

BFR percentages ~100% AOP at 90% 1RM improved acutely MPV (only in SQ exercises) and reduced acutely perceived exertion (in both exercises). These findings are important to consider when prescribing resistance training for healthy male athletes.

Effects of Resistance Training with Blood Flow Restriction on Explosive Power of Lower Limbs: A Systematic Review and Meta-Analysis

The purpose of this systematic review and meta-analysis was to compare changes in explosive power between blood flow restriction training and traditional resistance training protocols. Searches of PubMed, Scopus, Web of Science, and OVID Medline were conducted for studies. Inclusion criteria were: (a) healthy people; (b) randomized controlled or controlled trials; (c) outcome measures of explosive performance (peak power, rate of force development, jump performance, sprint performance, etc.); (d) involving a comparison between blood flow restriction training and traditional resistance training. Quality assessment was conducted using the Physiotherapy Evidence Database (PEDro) scale. A total of 12 studies (262 subjects) were finally included for analysis. The PEDro scale score had a median of 5 of 10 points (range: 3-6 points). Significant small to moderate improvements were observed in blood flow restriction training [jump: standard mean difference (SMD) of 0.36 (95% CI: 0.02; 0.69); sprint: SMD of 0.54 (95% CI: 0.00; 1.07); power: SMD of 0.72 (95% CI: 0.17; 1.27)] when compared to traditional resistance training. The findings indicate that blood flow restriction training is more effective in improving explosive power of lower limbs compared to traditional resistance training in healthy people. In addition, blood flow restriction with a wide cuff (≥ 10 cm) during training improved explosive power better than with a narrow cuff or during the rest interval. Blood flow restriction training is very suitable for athletes in short competitive seasons and those who are not able to tolerate high loads (i.e., rehabilitators and the elderly).

Effects of whole-body vibration training combined with KAATSU training on lower limb joint muscle strength in older women

Objective: This study aimed to investigate the effect of whole-body vibration training (WBVT) combined with KAATSU training (KT) on lower limb joint muscle strength and to provide a reference for improving muscle strength in older women. Methods: A total of 86 healthy older people was randomly divided into WBVT group (WG, n = 21), KT group (KG, n = 22), combined intervention group (CIG, n = 20) and control group (CG, n = 23). WG and CIG subjects underwent WBVT, and KG and CIG subjects underwent 150 mmHg and lower limb joint and local compression intervention for 16 weeks (three times per week, about 15 min/time). The peak torque (PT) and endurance ratio (ER) of joint flexion or extension were tested for all subjects. Results: 1) Results at 16 weeks were compared with the baseline data. The knee extension and ankle flexion PT (60°/s) in CIG increased by 14.3% and 15.3%, respectively (p < 0.05). The knee extension PT (180°/s) increased by 16.9, 18.4% and 33.3% in WG, KG and CIG (p < 0.05), respectively, and the ankle extension PT (180°/s) in CIG increased by 31.1% (p < 0.05). The hip, knee extension and ankle flexion ER increased by 10.0, 10.9% and 5.7% in CIG (p < 0.05), respectively. 2) Results were compared among groups at 16 weeks. The relative changes were significantly lower in WG, KG and CG compared to CIG in the knee extension and ankle flexion PT (60°/s) (p < 0.05). The relative changes were significantly greater in WG, KG and CIG compared to CG in the knee extension PT (180°/s) (p < 0.05). The relative changes were significantly lower in WG, KG and CG compared to CIG in the ankle extension PT (180°/s) (p < 0.05). The relative changes were significantly lower in WG, KG and CG compared to CIG in the hip extension ER (p < 0.05). The relative changes were significantly lower in CG compared to CIG in the knee extension ER (p < 0.05). Conclusion: Sixteen-week WBVT and KT increased the knee extensor strength in older women. Compared with a single intervention, the combined intervention had better improvements in the knee extensor and ankle flexor and extensor strength and hip extension muscle endurance. Appears to be some additional benefit from combined intervention above those derived from single-interventions.

Effects of blood flow restriction on mechanical properties of the rectus femoris muscle at rest

Introduction: This study examined the effects of blood flow restriction (BFR) and reperfusion on the mechanical properties of the rectus femoris muscle at rest (frequency and stiffness). Methods: Fourteen trained men (body weight = 81.0 ± 10.3 kg; BMI = 25 ± 3.0 m/kg2; height = 181 ± 4 cm; training experience = 6.0 ± 2.2 years) participated in an experimental session involving their dominant (BFR) and non-dominant leg (control). Muscle mechanical properties were measured using Myoton's accelerometer at the midpoint of the rectus femoris muscle at five time points. In the BFR leg, an 80% arterial occlusion pressure was applied by a cuff for 5 min. No cuff was applied in the control leg. Femoral Myoton measurements were taken from both legs 2 and 4 min after the start of BRF as well as 30 s and 2 min after the end of the occlusion period. Results: The two-way ANOVA revealed a statistically significant interaction effect for stiffness and frequency (p < 0.001; η2 > 0.67). The post hoc analysis showed that both stiffness and frequency increased during BFR compared with rest and then dropped to the resting levels post BFR period. Also, stiffness and frequency were higher than control only during the BFR period, and similar during rest and post BFR. Conclusion: These results indicate that the application of BFR at rest leads to significant changes in mechanical properties of the rectus femoris muscle.

Acute Effects of Blood Flow Restriction Training on Movement Velocity and Neuromuscular Signal during the Back Squat Exercise

The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back squat exercise.

METHODS

Twenty-four university students participated in this study. In two randomized sessions 72 h apart, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity (MPV), peak concentric velocity (Vmax), and the effort index (EI)). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs.

RESULTS

The BFR condition showed higher (p < 0.05) EI, peak, and rooted mean square normalized EMG in Set 1 compared to Set 2. Similar MPV and Vmax were observed in each set for both the BFR and control conditions. No significant differences were observed between conditions in any set.

CONCLUSIONS

BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less excitation of the muscles involved.

Acute effects of different external compression with blood flow restriction on force-velocity profile during squat and bench press exercises

The aim was to compare the acute effects of bench press (BP) and squat (SQ) exercises with blood flow restriction (BFR) (40%, 60%, 80% and 100% of the complete arterial occlusion pressure (AOP)) and without BFR (CON) on the mean propulsive (Vel_MED) and maximum (Vel_MAX) bar velocity. Fourteen healthy, physically active males (age, 23.6 ± 4.1 years; height, 1.85 ± 0.11 m; body weight 85.4 ± 4.1 kg) took part in the study. There was one set for each testing condition (CON, 40%, 60%, 80% and 100%) with 6 repetitions for BP and 6 repetitions for SQ, at 60% of 1RM, and 3 minutes of recovery between sets. The results showed statistically significant differences of the sets with 80% BFR vs. CON (mean difference [MD] = 0.035 m · s^-1, p < 0.05, ES = 0.52 [1.02-0.03]) and 100% BFR sets vs. CON (MD = 0.074, p < 0.001, ES = 1.08 [1.79-0.38]) for BP. In the SQ exercise, statistically significant differences were found between 100% BFR vs. CON (DM = 0.031 m · s^-1, p < 0.05), vs. 100% BFR 40% (MD = 0.04 m · s^-1, p < 0.05). Trend analysis showed a statistically significant linear trend (F[1,9] = 34.9, p < 0.001, F[1,13] = 27.32, p < 0.001) for the Vel_MED in relation to the different levels of BFR. In conclusion, our results showed that BFR levels above ˜80% AOP (BP) and ˜100% AOP (SQ) produce a Vel_MED improvement at 60% 1RM.

Neuromuscular Impact of Acute Hypertrophic Resistance Loading With and Without Blood-Flow Restriction

Exploring acute neuromuscular fatigue induced by different modalities of resistance exercise would help understand the adaptation subsequent to specific training programs. Therefore, we investigated the acute impact of high-intensity and low-intensity blood flow-restricted resistance exercise on the development of explosive torque throughout the torque-time curve. Seventeen healthy, young participants were included in a randomized, counterbalanced within-subjects design study, in which participants underwent two experimental conditions, separated by a 1-wk period. Low-intensity blood-flow restricted exercise and high-intensity resistance exercise were performed using dynamic elbow flexion at 20 and 75% of 1 repetition maximum, respectively. Maximal voluntary contraction (MVC) and the sequential rate of torque development (absolute and relative) were measured before and after exercise. Both protocols elicited a similar decrement in MVC (~ 25%) and in the peak rate of torque development after exercise (~ 45%). The absolute rate of torque development (0-50 and 50-100 ms) was also reduced (p<0.05) similarly between conditions. After normalizing torque values to MVC, this was only sustained for the rate of torque development 0-50ms (p<0.05). We found that both exercise protocols induced similar acute attenuation of the absolute rate of torque development up to the first 100 ms of MVC. We also demonstrated that the reduction in the rate of torque development between 50-100ms (in both protocols) was largely explained by an acute deficit in muscle strength post-exercise. Conversely, the impact of each protocol on the first 50ms of muscle torque did not depend on lower levels of muscle strength after exercise.

Ischemia during rest intervals between sets prevents decreases in fatigue during the explosive squat exercise: a randomized, crossover study

The study aimed to evaluate the impact of ischemia, used only before particular sets of a lower limb resistance exercise on power output. Ten healthy resistance-trained males (age = 26 ± 6 years; body mass = 90 ± 9 kg; training experience = 9 ± 7 years) performed two experimental sessions (with ischemia; control without ischemia) following a randomized crossover design. During the ischemic condition, the cuffs were inflated to 60% of arterial occlusion pressure. The cuffs were applied before each set for 4.5 min and released 30 s before the start of the set as the reperfusion (4.5 min ischemia + 0.5 min reperfusion). In the control condition, ischemia was not applied. During the experimental sessions, the subjects performed the Keiser machine squat exercise protocol which consisted of 5 sets of two repetitions, at a load of 60% of one-repetition maximum (1RM), with 5 min rest intervals between sets. The repetitions were performed with maximal velocity. The two-way repeated-measures ANOVA showed a statistically significant interaction effect for power output (p < 0.01; η² = 0.26). There was also a statistically significant main effect of condition for power output (p = 0.02; η² = 0.40). The post hoc analysis for interaction did not show significant differences between conditions in particular sets. The post hoc analysis for the main effect of the condition revealed that power output was significantly lower in the control group compared to the group where ischemic was used (p = 0.02). The t-test comparisons for particular sets showed a significant lower power output in set 3 (p = 0.03); set 4 (p < 0.01) and set 5 (p < 0.01) for the control condition when compared to the ischemic condition. The results indicate that ischemia applied before each set and released 30 s prior to the start of the squat exercise did not increase power output performance. However, we observed a significantly lower decline in power for the ischemic condition (4.5 min ischemia + 0.5 min reperfusion) in sets 3–5 compared to the control condition. Thus repeated ischemia with reperfusion used between sets can be an effective form of performance enhancement by preventing or at least diminishing fatigue during resistance exercise.

Acute impact of blood flow restriction on strength-endurance performance during the bench press exercise

The main goal of the present study was to evaluate the acute effects of blood flow restriction (BFR) at 70% of full arterial occlusion pressure on strength-endurance performance during the bench press exercise. The study included 14 strength-trained male subjects (age = 25.6 ± 4.1 years; body mass = 81.7 ± 10.8 kg; bench press 1 repetition maximum (1RM) = 130.0 ± 22.1 kg), experienced in resistance training (3.9 ± 2.4 years). During the experimental sessions in a randomized crossover design, the subjects performed three sets of the bench press at 80% 1RM performed to failure with two different conditions: without BFR (CON); and with BFR (BFR). Friedman's test showed significant differences between BFR and CON conditions for the number of repetitions performed (p < 0.001); for peak bar velocity (p < 0.001) and for mean bar velocity (p < 0.001). The pairwise comparisons showed a significant decrease for peak bar velocity and mean bar velocity in individual Set 1 for BFR when compared to CON conditions (p = 0.01 for both). The two-way repeated measures ANOVA showed a significant main effect for the time under tension (p = 0.02). A post-hoc comparisons for the main effect showed a significant increase in time under tension for BFR when compared to CON (p = 0.02). The results of the presented study indicate that BFR used during strength-endurance exercise generally does not decrease the level of endurance performance, while it causes a drop in bar velocity.

Myoelectric Activity and Fatigue in Low-Load Resistance Exercise With Different Pressure of Blood Flow Restriction: A Systematic Review and Meta-Analysis

Background: Low-load resistance exercise (LL-RE) with blood flow restriction (BFR) promotes increased metabolic response and fatigue, as well as more pronounced myoelectric activity than traditional LL-RE. Some studies have shown that the relative pressure applied during exercise may have an effect on these variables, but existing evidence is contradictory.

Purpose: The aim of this study was to systematically review and pool the available evidence on the differences in neuromuscular and metabolic responses at LL-RE with different pressure of BFR.

Methods: The systematic review and meta-analysis was reported according to PRISMA items. Searches were performed in the following databases: CINAHL, PubMed, Scopus, SPORTDiscus and Web of Science, until June 15, 2021. Randomized or non-randomized experimental studies that analyzed LL-RE, associated with at least two relative BFR pressures [arterial occlusion pressure (AOP)%], on myoelectric activity, fatigue, or metabolic responses were included. Random-effects meta-analyses were performed for MVC torque (fatigue measure) and myoelectric activity. The quality of evidence was assessed using the PEDro scale.

Results: Ten studies were included, all of moderate to high methodological quality. For MVC torque, there were no differences in the comparisons between exercise with 40–50% vs. 80–90% AOP. When analyzing the meta-analysis data, the results indicated differences in comparisons in exercise with 15–20% 1 repetition maximum (1RM), with higher restriction pressure evoking greater MVC torque decline (4 interventions, 73 participants; MD = −5.05 Nm [95%CI = −8.09; −2.01], p = 0.001, I² = 0%). For myoelectric activity, meta-analyses indicated a difference between exercise with 40% vs. 60% AOP (3 interventions, 38 participants; SMD = 0.47 [95%CI = 0.02; 0.93], p = 0.04, I² = 0%), with higher pressure of restriction causing greater myoelectric activity. This result was not identified in the comparisons between 40% vs. 80% AOP. In analysis of studies that adopted pre-defined repetition schemes, differences were found (4 interventions, 52 participants; SMD = 0.58 [95%CI = 0.11; 1.05], p = 0.02, I² = 27%).

Conclusion: The BFR pressure applied during the LL-RE may affect the magnitude of muscle fatigue and excitability when loads between 15 and 20% of 1RM and predefined repetition protocols (not failure) are prescribed, respectively.

Systematic Review Registration: [http://www.crd.york.ac.uk/prospero], identifier [CRD42021229345].

The Effects of Ischemia During Rest Intervals on Bar Velocity in the Bench Press Exercise With Different External Loads

The main aim of the present study was to evaluate the acute effects of ischemia used during rest periods on bar velocity changes during the bench press exercise at progressive loads, from 20 to 90% of 1RM. Ten healthy resistance trained men volunteered for the study (age = 26.3 ± 4.7 years; body mass = 89.8 ± 6.3 kg; bench press 1RM = 142.5 ± 16.9 kg; training experience = 7.8 ± 2.7 years). During the experimental sessions the subjects performed the bench press exercise under two different conditions, in a randomized and counterbalanced order: (a) ischemia condition, with ischemia applied before the first set and during every rest periods between sets, and (b) control condition where no ischemia was applied. During each experimental session eight sets of the bench press exercise were performed, against loads starting from 20 to 90% 1RM, increased progressively by 10% in each subsequent set. A 3-min rest interval between sets was used. For ischemia condition the cuffs was applied 3 min before the first set and during every rest period between sets. Ischemia was released during exercise. The cuff pressure was set to ∼80% of full arterial occlusion pressure. The two-way repeated measures ANOVA showed a statistically significant interaction effect for peak bar velocity (p = 0.04) and for mean bar velocity (p = 0.01). There was also a statistically significant main effect of condition for peak bar velocity (p < 0.01) but not for mean bar velocity (p = 0.25). The post hoc analysis for interaction showed significantly higher peak bar velocity for the ischemia condition compared to control at a load of 20% 1RM (p = 0.007) and at a load of 50% 1RM (p = 0.006). The results of the present study indicate that ischemia used before each set even for a brief duration of <3 min, has positive effects on peak bar velocity at light loads, but it is insufficient to induce such effect on higher loads.

Acute Effects of Different Blood Flow Restriction Protocols on Bar Velocity During the Squat Exercise

The main goal of the present study was to evaluate the effects of different blood flow restriction (BFR) protocols (continuous and intermittent) on peak bar velocity (PV) and mean bar velocity (MV) during the squat exercise at progressive loads, from 40 to 90% 1RM. Eleven healthy men (age = 23.4 ± 3.1 years; body mass = 88.5 ± 12.1 kg; squat 1RM = 183.2 ± 30.7 kg; resistance training experience, 5.7 ± 3.6 years) performed experimental sessions once a week for 3 weeks in random and counterbalanced order: without BFR (NO-BFR), with intermittent BFR (I-BFR), and with continuous BFR (C-BFR). During the experimental session, the participants performed six sets of the barbell squat exercise with loads from 40 to 90% 1RM. In each set, they performed two repetitions. During the C-BFR session, the cuffs were maintained throughout the training session. During the I-BFR, the cuffs were used only during the exercise and released for each rest interval. The BFR pressure was set to ∼80% arterial occlusion pressure (AOP). Analyses of variance showed a statistically significant interaction for MV (p < 0.02; η² = 0.18). However, the post hoc analysis did not show significant differences between particular conditions for particular loads. There was no significant condition × load interaction for PV (p = 0.16; η² = 0.13). Furthermore, there were no main effects for conditions in MV (p = 0.38; η² = 0.09) as well as in PV (p = 0.94; η² = 0.01). The results indicate that the different BFR protocols used during lower body resistance exercises did not reduce peak bar velocity and mean bar velocity during the squat exercise performed with various loads.

Effects of Resting vs. Continuous Blood-Flow Restriction-Training on Strength, Fatigue Resistance, Muscle Thickness, and Perceived Discomfort

Introduction: The purpose of this study was to clarify whether blood-flow restriction during resting intervals [resting blood-flow restriction (rBFR)] is comparable to a continuous BFR (cBFR) training regarding its effects on maximum strength, hypertrophy, fatigue resistance, and perceived discomfort. Materials and Methods: Nineteen recreationally trained participants performed four sets (30-15-15-15 repetitions) with 20% 1RM on a 45° leg press twice a week for 6 weeks (cBFR, n = 10; rBFR, n = 9). Maximum strength, fatigue resistance, muscle thickness, and girth were assessed at three timepoints (pre, mid, and post). Subjective pain and perceived exertion were determined immediately after training at two timepoints (mid and post). Results: Maximum strength (p < 0.001), fatigue resistance (p < 0.001), muscle thickness (p < 0.001), and girth (p = 0.008) increased in both groups over time with no differences between groups (p > 0.05). During the intervention, the rBFR group exposed significantly lower perceived pain and exertion values compared to cBFR (p < 0.05). Discussion: Resting blood-flow restriction training led to similar gains in strength, fatigue resistance, and muscle hypertrophy as cBFR training while provoking less discomfort and perceived exertion in participants. In summary, rBFR training could provide a meaningful alternative to cBFR as this study showed similar functional and structural changes as well as less discomfort.

Impact of Ischemic Intra-Conditioning on Power Output and Bar Velocity of the Upper Limbs

This study evaluated the effects of ischemic conditioning on power output and bar velocity in the bench press exercise. Ten healthy males (age: 25 ± 2 years; body mass: 92 ± 8 kg; bench press one repetition maximum -1RM: 145 ± 13 kg), took part in two experimental sessions (with and without ischemia), 1 week apart in random and counterbalanced order. In the ischemic condition, cuffs placed around the upper part of the arms were inflated to 80% of arterial occlusion pressure before each set, while in the control condition there was no blood flow restriction. The exercise protocol included 5 sets of three repetitions each, against a resistance equal to 60% 1RM, with 5 min recovery intervals between sets. There was a main effect of condition for mean power output (MP) and mean bar velocity (MV) (p = 0.01), with overall MP being higher in ischemia than in control by 5.6 ± 4.1% (mean ± 90% compatibility limits), a standardized effect size (ES) of 0.51. Overall MV was also higher by 5.5 ± 4.0%, ES = 0.63. Peak power output (PP) and peak bar velocity (PV) were similar in set 1 of the control and ischemia condition (1039 ± 105 vs. 1054 ± 82 W; 684 ± 74 vs. 696 ± 53 W; 1.09 ± 0.07 vs. 1.12 ± 0.09 m/s; 0.81 ± 0.05 vs. 0.82 ± 0.05 m/s, p = 0.67 to 0.99, mean ± standard deviation). However, from set 3 onward (p = 0.03 to 0.001), PP and PV were higher in ischemia compared with control, with the highest difference observed in set 5 (10.9 ± 5.9%, ES = 0.73 for PP and 8.6 ± 4.6%; ES = 0.89 for PV). These results indicate that ischemia used before each set of the bench press exercise increases power output and bar velocity and this may be used as performance-enhancing stimulus during explosive resistance training.

The influence of compressive gear on maximal load lifted in competitive powerlifting

The competition in powerlifting has been divided into two divisions, with gear equipment (EQ) and without gear equipment (RAW). When competing in the EQ division, additional supportive gear can be worn by the athletes, while in the RAW division such gear is not allowed. The aim of the study was to compare the results of the RAW and EQ powerlifting divisions based on the results of world championships and current world records. One-hundred and twenty powerlifters (63 men, 57 women) were included to the analysis. Post hoc analysis for the results of men’s world championships indicated significantly higher results of the barbell squat (SQ; p < 0.001; ES = 1.31), bench press (BP; p < 0.001; ES = 1.27) and deadlift (DL; p < 0.001; ES = 0.37) for EQ compared to the RAW division. Post hoc analysis for the results of women’s world championships indicated significantly higher results of the SQ (p < 0.001; ES = 1.31), BP (p < 0.001; ES = 1.13) and DL (p < 0.001; ES = 0.71) for the EQ compared to the RAW division. Post hoc analysis for men’s world record indicated significantly higher results in the SQ (p < 0.001; ES = 1.32) and BP (p < 0.001; ES = 1.24) for the EQ compared to the RAW division. Furthermore, there were no significant differences in the results of world records in the DL (p = 0.901; ES = 0.26) between the EQ and RAW divisions. Post hoc analysis for women’s world records indicated significantly higher results in the SQ (p < 0.001; ES = 1.22) and BP (p < 0.001; ES = 1.99) for the EQ compared to RAW division. The main finding of the study was that supportive gear increases maximal load lifted during powerlifting competition.