Effect of Blood Flow Restriction Training on Physiological Outcomes in Healthy Athletes: a Systematic Review and Meta-Analysis

Abstract

Background. Blood flow restriction (BFR) training is gaining increasing attention in the scientific community. Studies using exercise combined with blood flow restriction have shown muscle strength and size improvement. In fact, the main feature of BFR training is that can elicit muscle hypertrophy and strength adaptations using light external loads (20-30% one repetition maximum, 1RM) comparable to what is typically seen following high-load (HL) training programs with 70-85% 1RM. This specific training has applications for individuals who may not be able to tolerate the mechanical stresses associated with higher loads, such as the elderly or injured; thus, several investigations have focused on implementing BFR exercise within older and clinical populations. However, the effects of this kind of technique in healthy athletes are not clear in scientific literature. The purpose of this study is to conduct a systematic review with meta-analysis to evaluate the qualitative and quantitative results of blood flow restriction training in healthy athletes. Methods. PRISMA guidelines were used to carry out the systematic review and meta-analysis. Three electronic databases were searched: MEDLINE, PEDro, and the Cochrane Library. Papers included in the study have the following characteristics: a) a randomized controlled trial or clinical trial design of research, b) studies investigating physiological effects of BFR training in healthy athletes and c) published in English. The approach to data extraction was chosen on the basis of the Cochrane Methods. Studies quality and risk of bias of the clinical trials included were evaluated according to a Jadad score and through meta-analysis. Results. After the elimination of duplicates, 164 records were screened. Among these, 14 studies were included in the systematic review. Seven of these were involved in the meta-analysis. From the qualitative analysis, a larger number of studies were found with a low level of quality. Conclusions. The application of BFR positively influences muscular adaptations compared with exercise under normal blood-flow conditions, in terms of increased VO 2 max, higher strength increase, and muscles adaptations. Thus, BFR provides a feasible, promising, and beneficial complementary training stimuli when used in a controlled environment supervised by trained and experienced personnel.

Low‐intensity swimming with blood flow restriction over 5 weeks increases VO2peak: A randomized controlled trial using Bayesian informative prior distribution

“…In line with these findings regarding VO 2 peak improvements, several systematic reviews (Bennett & Slattery, 2018;Pignanelli et al, 2021) and meta-analyses (Floco & Bernabei, 2022;Floco & Galeoto, 2021;Formiga et al, 2020;Slysz et al, 2016) confirmed VO 2 max improvements via BFR training compared to similar training content without BFR in healthy (Bennett & Slattery, 2018;Floco & Bernabei, 2022;Formiga et al, 2020;Slysz et al, 2016) and trained athletes (Floco & Galeoto, 2021;Pignanelli et al, 2021). The current BFR settings were adapted from a previous successfully conducted rowing trial (Held et al, 2020).…”

“…In line with these findings, BFR training has been successfully applied during both aerobic and resistance training and can result in notable improvements in strength and endurance capacity (Loenneke et al, 2012;Patterson et al, 2019;Scott et al, 2016). Regarding the VO 2 max, several systematic reviews (Bennett & Slattery, 2018;Pignanelli et al, 2021) and meta-analyses (Floco & Bernabei, 2022;Floco & Galeoto, 2021;Formiga et al, 2020;Slysz et al, 2016) revealed compelling evidence on VO 2 max improvements via BFR training compared to similar training content without the application of BFR.…”

“…Therefore, both swimming speed at corresponding lactate thresholds (Pyne et al, 2001) and maximal oxygen consumption (VO 2 max) (Fernandes & Vilas-Boas, 2012) are considered highly relevant performance surrogates in competitive swimming. Complementary blood flow restriction (BFR) training has been shown to be a promising training tool in order to improve VO 2 max during low intensity endurance training across a variety of different disciplines (Floco & Bernabei, 2022;Floco & Galeoto, 2021;Formiga et al, 2020;Slysz et al, 2016).…”

Local, Distal, Proximal, and Contralateral Effects of Low-Load Blood Flow Restriction Training on Upper Extremity Neuromuscular Performance of Healthy Women: a Randomized Placebo-Controlled Trial Protocol

“…High-load training and low-load BFR training may induce similar hypertrophy levels in healthy people (6). However, literature regarding muscle strength gains in this population is conflicting, with previous studies showing superiority (6,7) or similarity (8) of high-load resistance training versus low-load BFR training. Furthermore, it is suggested that the occurrence of fatigue during low-load resistance training is similar between the conditions of restricted blood flow and free blood flow (9).…”

New Training Tasks for Stepwise Loading in Isometric Bodyweight Squat with Active Posture Control

“…The benefits of squat exercises have been reported in athletic training [1,2], rehabilitation [3,4], and locomotive syndrome in elderly people [5]. Squats can refer to a wide variety of exercises, comprising partial squat [6], half squat [7], parallel squat [8,9], full squat [8,9], and deep squat [7].…”