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In summary, the mechanisms that most probably play the largest role in the beneficial adaptations seen in BFR resistance training are related to accelerating the time to volitional failure of the muscles distal to the cuff. Metabolite accumulation and cell swelling secondary to the restrictive cuff provide a window to replicate a similar local muscular environment as
heavier lifting protocols through the earlier recruitment of type 2 fibers at lighter (20-50% 1RM) loads. The other mechanisms – hormone production, cross-transfer effects and SC proliferation are likely secondary reactions to local metabolic stress or BFR application and play variable roles in the response to chronic BFR training (Takada, 2012).