Bilateral upper limb remote ischemic preconditioning improves peak anaerobic power

Purpose: Ischemic preconditioning (IPC) has been used to protect myocardial cells against ischemia-reperfusion injury and is recently used for improving exercise performance. It is unknown whether a remote bout of IPC (RIPC) to tissue not involved in exercise can induce similar exercise improvements and what “dose” of IPC is necessary to induce exercise performance benefits. This study determined if unilateral and bilateral upper limb RIPC improves lower body anaerobic power output. Methods: Using two randomized, single blind, crossover study designs, we studied 43 young recreationally active adults. For study 1, unilateral RIPC was used and a sham control condition involved the inflation of blood pressure cuffs to 10 mm Hg. For study 2, the ischemic stimuli were increased to bilateral occlusion while the sham control condition used was 0 mm Hg of occlusion pressure. After the RIPC treatment, subjects completed four 30 s Wingate anaerobic tests on a Monark cycle ergometer with 2 min passive rest between trials. Results: In the unilateral occlusion trial, peak power, mean power, and fatigue index were not different between the two conditions at every Wingate test. In the bilateral occlusion trial, peak power was elevated in the RIPC condition than in the sham control for the fourth Wingate test (p<0.05). Additionally, compared with the sham control, mean power was greater in the RIPC condition during the first and fourth Wingate tests (both p<0.05). Conclusion: Remote ischemic preconditioning applied bilaterally increased lower body power output over a series of Wingate anaerobic tests. Unilateral RIPC, however, had no effect on any of the performance variables, suggesting that there is a threshold for the amount of target tissue needed to elicit anaerobic performance benefits.