Effects of Blood Flow Restriction Training on Aerobic Capacity and Performance: A Systematic Review

Abstract

Bennett, H and Slattery, F. Effects of blood flow restriction training on aerobic capacity and performance: A systematic review. J Strength Cond Res 33(2): 572–583, 2019—Blood flow restriction (BFR) is a novel training method that can elicit training adaptations at low training intensities. Recent research has aimed to determine the effect of aerobic exercise with BFR on aerobic fitness and performance, with conflicting results. This review aimed to systematically identify and assess studies that have combined BFR with aerobic exercise in humans, establishing its effect on aerobic fitness and performance. Five databases (Medline, Web of Science, SPORTDiscus, CINHAL, and ScienceDirect) were searched. Two authors independently conducted all searches and reviewed all abstracts, determining article suitability. The Quality Assessment Tool for Quantitative Studies was used to assess risk of bias in each study. Fourteen studies were included for analysis. Blood flow restriction aerobic exercise increased measures of aerobic fitness and performance in younger adults when using occlusion pressures ≥130 mm Hg. In older adults, measures of aerobic performance improved; however, measures of aerobic fitness remained unchanged. These findings must be interpreted with caution because methodological limitations were present in all trials. Short-term BFR aerobic exercise seems to offer a valid method of improving aerobic performance and fitness in healthy adults when using occlusion pressures ≥130 mm Hg. Conversely, it seems to strictly enhance aerobic performance in older adults without impacting aerobic fitness, potentially suggesting different mechanisms of adaptation between older and younger individuals. Despite methodological limitations, BFR aerobic exercise seems to have applications in scenarios where high-intensity aerobic exercise is not appropriate, although more high-quality research is needed to further demonstrate this.

Blood flow restriction training: You can occlude your veins, but not your oxygen transport

“…2020). This result demonstrates an important impact of BFR on improvement of endurance performance, similar to those reported in previous studies (Sundberg, 1994; Bennett & Slattery, 2019).…”

“…Enhanced O 2 transport and consequently delayed onset of lactate accumulation improved post-training PO in the BFR-leg (11%) (Christiansen et al 2020). This result demonstrates an important impact of BFR on improvement of endurance performance, similar to those reported in previous studies (Sundberg, 1994;Bennett & Slattery, 2019).…”

“…BFR training presents a novel exercise modality, where pneumatic cuffs are placed on the limbs (arms or legs) and are inflated above the levels of systolic arterial pressure with the aim of occluding arterial blood flow and venous return. Occlusion of blood flow causes a decline in oxygen (O 2 ) and metabolite transport, as well as an increase in heart rate, blood pressure, muscle fibre recruitment and hormone production (Sundberg, 1994; Bennett & Slattery, 2019). When combined with exercise, such a local hypoxic stimuli provokes a physiological adaptation similar to those observed during maximal exertions, with this occurring when performing exercise at lower intensities (Bennett & Slattery, 2019).…”

“…By contrast, only a few studies have used BFR during aerobic training (e.g. walking, cycling) and have shown conflicting results on aerobic capacity and exercise performance (Bennett & Slattery, 2019), although none of them assessed the potential of skeletal muscle O 2 transport and utilization adaptations to BFR training. The latter may present an important training target for improving maximum O 2 uptake () (Wagner, 1996).…”

Effects of Walking Training with Restricted Blood Flow on HR and HRV Kinetics and HRV Recovery

“…Thus, low-intensity training with BFR seems to be an interesting alternative for people unable to perform high intensity exercise and individuals in the aging process, because this type of training improves cardiovascular health and prevents negative alterations related to aging [31,34]. Further studies are required in order to investigate different intensities and different exercise modalities, and whether in high intensities the BFR promotes additional benefits.…”