Effect of Blood Flow Restriction on Functional, Physiological and Structural Variables of Muscle in Patients with Chronic Pathologies: A Systematic Review

Abstract

The main objective of this systematic review of the current literature is to analyze the changes that blood flow restriction (BFR) causes in subjects with neuro-musculoskeletal and/or systemic pathologies focusing on the following variables: strength, physiological changes, structural changes and cardiocirculatory variables. The search was carried out in seven databases, including randomized clinical trials in which therapeutic exercise was combined with the blood flow restriction tool in populations with musculoskeletal pathologies. Outcome variables are strength, structural changes, physiological changes and cardiocirculatory variables. Twenty studies were included in the present study. Although there is a lot of heterogeneity between the interventions and evaluation instruments, we observed how the restriction of blood flow presents significant differences in the vast majority of the variables analyzed. In addition, we observed how BFR can become a supplement that provides benefits when performed with low intensity, similar to those obtained through high-intensity muscular efforts. The application of the BFR technique can provide benefits in the short and medium term to increase strength, muscle thickness and cardiovascular endurance, even improving the physiological level of the cardiovascular system. In addition, BFR combined with low-load exercises also achieves benefits comparable to high-intensity exercises without the application of BFR, benefiting patients who are unable to lift high loads.

Current Implementation and Barriers to Using Blood Flow Restriction Training: Insights From a Survey of Allied Health Practitioners

“…Considering that BFR training likely has the greatest utility for individuals who cannot tolerate the mechanical demands of vigorous activity (24), it is perhaps more meaningful to understand how the technique is implemented by allied health professionals working with such populations (i.e., older people, those with clinical conditions or recovering from injury). Safety concerns regarding BFR typically focus on these populations, who may be at an increased risk of adverse side effects (29).…”

Beneficial Role of Blood Flow Restriction Exercise in Heart Disease and Heart Failure Using the Muscle Hypothesis of Chronic Heart Failure and a Growing Literature

“…The reduction in blood flow and subsequent hypoxia within exercising skeletal muscle during BFRE stimulates anaerobic metabolism and metabolite accumulation promoting rapid muscular fatigue, up-regulated muscle protein synthesis, systemic anabolic hormone release, and possibly angiogenesis. ( Loenneke et al, 2012 ; Pignanelli et al, 2021 ; May et al, 2022 ; Reina-Ruiz Á et al, 2022 ). However, BFR during exercise does elicit a greater increase in hemodynamic response which appears to be less during aerobic exercise compared to resistance training.…”

Effectiveness of Blood Flow Restriction in Neurological Disorders: A Systematic Review

“…There is also scientific evidence that the combined application of BFR and electrical stimulation reduces muscle wasting in the legs [ 6 ]. A recently published review concluded that the application of the BFR technique can produce short- and medium-term benefits in increasing strength, muscle density and cardiovascular endurance in patients with chronic pathologies [ 9 ].…”