Ischemic preconditioning combined with inter-set palm cooling enhances performance in strength-trained men during high-intensity resistance training: A randomized crossover trial
Wu, C. M., Chou, W. C., Wang, W. Y., & Cai, Z. Y. (2025). Ischemic preconditioning combined with inter-set palm cooling enhances performance in strength-trained men during high-intensity resistance training: A randomized crossover trial. Biology of sport, 43, 139–147. https://doi.org/10.5114/biolsport.2026.152344
Introduction: This study investigated the effects of ischemic preconditioning (IPC) on performance during highintensity resistance exercise (RE) sessions, as well as the additional effects of inter-set palm cooling (PC) and the potential underlying mechanisms.
Methods: Twelve resistance-trained men participated in three RE sessions in a randomized order: (1) IPC followed by RE with inter-set PC (15°C for 2.5 minutes), (2) IPC followed by RE, (3) SHAM followed by RE. IPC involved four cycles of 5-minute ischemia/5-minute reperfusion at 220 mmHg on the upper arm, whereas SHAM involved 20 mmHg with a pneumatic cuff. The RE protocol included three sets to exhaustion, consisting of six exercises at 85% of one-repetition maximum. Multiple perceptual parameters were assessed during RE, and blood samples were obtained both before and after four cycles of ischemia/reperfusion as well as after RE.
Results: The results indicated that compared with SHAM, IPC significantly increased the total work volume (∆ = 2.6%); the total number of repetitions (∆ = 4.3%); the number of repetitions in specific exercises; and the levels of several arousal indicators, such as norepinephrine levels before RE and arousal level (assessed using the Felt Arousal Scale) during RE (p < 0.05). The IPC + PC combination further outperformed SHAM alone in most parameters (p < 0.05). However, fatigue indicators (rating of perceived exertion and lactate level) did not differ significantly across the protocols.
Conclusions: In conclusion, this study suggest that IPC enhances high-intensity RE performance, potentially through increased arousal levels, with PC augmenting exercise performance by amplifying the arousal response.
Keywords: Number of repetitions, Total work volume, Peripheral cooling, Lactate, Norepinephrine
In Simple Terms:
This study tested whether briefly restricting blood flow to the arms before lifting (called ischemic preconditioning) can help people perform better during intense strength training. The researchers found that this technique helped trained men complete slightly more reps and more total work, likely because it increased alertness and “readiness” to perform. When palm cooling was added between sets, performance improved even more, although it did not change how tired the athletes felt or their lactate levels.
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