Thrones, Mikal2025-09-082025-09-082025-08-262025-08-262025-09-08http://hdl.handle.net/1993/39312Creatine monohydrate (CM) is a supplement which enhances performance during high-intensity, short-duration resistance exercise. Its ergogenic effects are primarily attributed to increased intramuscular phosphocreatine (PCr) availability, facilitating ATP resynthesis during repeated bouts of muscular work. While CM has consistently demonstrated performance-enhancing effects in traditional resistance training, its efficacy during blood-flow restricted resistance exercise (BFR-RE) remained unexplored. The proposed study evaluated the ergogenic effects of CM during BFR-RE, with the aim of expanding current understanding of its utility in emerging resistance-training modalities. Thirteen participants (7 males, 6 females) completed the crossover protocol. Participants performed four sets of three lower-body BFR-RE exercises (leg press, knee flexion, knee extension) under both CM and placebo conditions. A 4-way mixed ANOVA was conducted to determine significant effects. There was a significant main effect of treatment, with participants completing more total repetitions under CM (277.38 ± 83.06) compared to placebo (251.62 ± 91.73), p = .004. A significant main effect of exercise was observed, with repetition performance highest during the leg press, followed by knee flexion, and lowest during knee extension (p < .001). A significant main effect of set was also found, with repetitions decreasing progressively from set 1 through set 4 (p < .001). Significant two-way interactions included treatment × exercise (p = .033), where CM led to higher repetitions in the leg press (p < .001) and knee extension (p = .015), but not knee flexion (p = .710); and treatment × set (p = .038), where CM increased repetitions primarily in set 1 (p = .02). A three-way interaction between sex × treatment × exercise (p = .038) indicated that males experienced a greater ergogenic benefit from CM in the leg press, while females showed no significant differences between conditions across exercises. Additionally, a sex × treatment × set interaction (p = .009) showed CM improved male performance in sets 1 and 2, but not in later sets, with no significant effects observed in females. In summary, CM supplementation acutely enhanced repetition performance during BFR-RE, particularly in multi-joint exercises and early sets, with more pronounced effects in males. These findings suggest CM may be an effective strategy for augmenting BFR-RE performance, which may result in greater outcomes following BFR-RE training programs.engCreatine MonohydrateBlood-Flow Restricted Resistance Exercise