Blood flow restriction (occlusion) training

NewsBot · Feb 26, 2024

Effect of Neuromuscular Electrostimulation With Blood Flow Restriction on Acute Muscle Swelling of the Abductor Hallucis
Kazunori Okamura et al
J Sport Rehabil. 2023 Dec 28;33(2):121-127.

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis.

Design: Randomized, controlled, single-blind trial design.

Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations.

Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P < .001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P < .001 and P = .001, respectively).

Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR.
Click to expand...

NewsBot · Apr 16, 2024

Feasibility of Blood Flow Restriction Exercise in Adults with a Non-surgically Treated Achilles Tendon Rupture; a Case Series
ANDREAS BENTZEN et al
International Journal of Exercise Science 17(3): 140-153, 2024.

Blood flow restriction exercise (BFRE) appears to provide a unique opportunity to preserve lower limb muscle and function in patients with an Achilles tendon rupture. The purpose of this study was to investigate the feasibility of BFRE in patients with an Achilles tendon rupture. Additionally, to evaluate muscle volume and patient-reported ankle function, symptoms, complications, and physical activity following 12 weeks of BFRE. Feasibility was measured by adherence to training sessions, drop-out rate, intervention acceptability, ankle pain exacerbation (NRS), and adverse events. At baseline and 12-weeks follow-up, patients completed the Achilles Tendon Total Rupture Score questionnaire and had their thigh and calf circumference measured. At follow-up, patients’ ability to perform a single-leg heel rise was tested. Sixteen of 18 patients completed the intervention and for those, adherence to training sessions was 88% ±16%. The mean NRS following BFRE sessions was 1.1 (95%CI: 1; 1.2). Three adverse events occurred during the 12 weeks. Two re-ruptures after completion of the BFRE program and one deep venous thrombosis following cast removal. BFRE was found to be feasible in a subset of patients with an Achilles tendon rupture. However, with three adverse events in a population of 18 patients, the effectiveness and safety of BFRE warrants further investigation.
Click to expand...

NewsBot · Jul 21, 2024

Comparison of Adaptations in the Gastrocnemius Muscle from an Exercise Program with and without Low-Intensity Blood Flow Restriction Banding in 18 Male Amateur Basketball Players Aged 16-45 Years
Enkeleda Gjini et al
Med Sci Monit. 2024 Jul 14:30:e944627

BACKGROUND Basketball is a sport with a global impact and recognized major leagues, and is one of the most studied and analyzed sports for improvement at the level of the high-performance athlete. Increasing the jump height of basketball players is an essential factor for high athletic performance. MATERIAL AND METHODS This study aimed to identify the effect of low-intensity training with flow restriction versus the eccentric exercise protocol on amateur athletes. Eighteen amateur basketball players aged 16-45 years were divided into 2 groups: Group A consisted of 9 participants with low-intensity training with flow restriction (40% intensity) with 200 mmHg occlusion applying flow restriction bands in the popliteal area, while Group B consisted of 9 participants who performed an eccentric exercises protocol on the gastrocnemius. An anthropometric evaluation was applied, which consisted of perception of effort, range of movement (ROM), muscle strength intensity, and the power of the jump measured with a jump platform. RESULTS Notable changes were observed in favor of Group A for the right dorsiflexion, with mean difference (MD)=-2.444 (P=0.018); left dorsiflexion with MD=-2.778 (P=0.027) and left foot perimeter variable with MD=-0.667 (P=0.026) at 95% confidence interval (CI); while the vertical jump was in favor of Group B, with MD=-2.899 (P=0.006). CONCLUSIONS Low-intensity training with flow restriction and eccentric exercise protocol were both effective in improving jumping performance. A significant improvement was shown in the jump height and ROM of the 2 study groups.
Click to expand...

NewsBot · Jul 25, 2024

Blood flow restriction training for an individual with Kellgren-Lawrence grade 4 ankle osteoarthritis following childhood clubfoot repair: A case report
Naaja Petersson , Stian Langgård Jørgensen
Physiother Theory Pract. 2024 Jul 17:1-6

Background: Ankle osteoarthritis (OA) is a disease involving pain and decreased physical function which can attenuate the tolerance to perform high-load resistance training. Low-load blood flow restriction (BFR) training has been demonstrated to improve muscle strength, muscle size, and physical function in patients suffering from OA.

Objective: We examined the effects of 12 weeks of BFR-training performed 4 times a week in an individual with Kellgren-Lawrence (KL) grade 4 ankle OA.

Case description: A 32-year-old woman with KL grade 4 right ankle OA subsequent to a clubfoot repair in childhood performed 12 weeks of BFR-training. Four exercises with concurrent blood flow restriction (60% of arterial occlusion pressure) targeting the lower leg were performed 4 times/week. The following outcome measures were collected at baseline and 12 weeks after BFR-training: The Foot and Ankle Outcome Score (FAOS), calf circumference, maximal isometric muscle strength, single-leg heel raise test, single-leg stance test, and lateral side-hop test.

Outcomes: Adherence to the training was 93.75%. The patient demonstrated improvements in FAOS subscale symptoms, pain, and sports/recreational activities by 19-47 points (minimal detectable change (MDC) = 18-21.5 points); maximal muscle strength in plantarflexion (36%), eversion (55%), and inversion (38%) (MDC for plantarflexion = 16.81-29.97%). The single-leg heel raise test and the lateral side-hop test improved with 66% and 51%, respectively. Calf circumference was maintained.

Conclusion: BFR-training improved patient-reported outcomes, lower leg muscle strength, and physical function in an individual suffering from KL grade 4 ankle OA following childhood clubfoot repair.
Click to expand...

NewsBot · Sep 24, 2024

The effectiveness of low-load Blood flow restriction Exercise in patients with an acute Achilles tendon rupture treated Non-surgically (BEAN): Protocol for a randomized controlled trial
Andreas Bentzen et al
Foot (Edinb). 2024 Sep 3

Background: Blood flow restriction exercise (BFRE) has been proposed as a viable method for preserving muscle mass and function after an injury during periods of load restrictions such as after an acute Achilles tendon rupture. However, its effectiveness and safety in patients with an Achilles tendon rupture have yet to be evaluated in a randomized trial.

Objectives: First, to investigate the effectiveness of early initiated BFRE in patients with non-surgically treated acute Achilles tendon rupture. Second, to evaluate whether it is better to apply BFRE in the beginning (1-12 weeks) or later (13-24 weeks) in the rehabilitation period.

Methods: This is an assessor-blinded, randomized, controlled multicenter trial with patients assigned in a 1:1 ratio to two parallel groups, that either receive BFRE in weeks 1-12 followed by usual care in weeks 13-24, or receive usual care in weeks 1-12 followed by BFRE in weeks 13-24. The BFRE program is performed three times weekly on the injured leg at 80 % of the pressure required to fully restrict the arterial blood flow. Post-intervention tests are conducted in week 13, comparing early BFRE with usual care, and in week 25, comparing early BFRE with late BFRE. At the 13-week evaluation, the primary outcome is the Single-Leg Heel-Rise test which assesses the patient's ability to raise the heel of the injured leg a minimum of 2 cm. At the 25-week evaluation, the primary outcome is the Achilles tendon Total Rupture Score which assesses the patient's self-reported symptoms and physical ability.
Click to expand...

NewsBot · Oct 26, 2024

Utility of hypoxic modalities for musculoskeletal injury rehabilitation in athletes: A narrative review of mechanisms and contemporary perspectives
Benjamin Jonathan Narang et al
Journal of Sports Sciences: 24 Oct 2024

Recent evidence suggests that different hypoxic modalities might accelerate the rehabilitation process in injured athletes. In this review, the application of hypoxia during rehabilitation from musculoskeletal injury is explored in relation to two principles: (1) facilitating the healing of damaged tissue, and (2) mitigating detraining and inducing training adaptations with a reduced training load. Key literature that explores the underlying mechanisms for these themes is presented, and considerations for practice and future research directions are outlined. For principle (1), passive intermittent hypoxic exposures might accelerate tissue healing through angiogenic and osteogenic mechanisms. Experimental evidence is largely derived from rodent research, so further work is warranted to establish whether clinically meaningful effects can be observed in humans, before optimal protocols are determined (duration, frequency, and hypoxic severity). Regarding principle (2), a hypoxia-related increase in the cardiometabolic stimulus imposed by low-load exercise is appealing for load-compromised athletes. As rehabilitation progresses, a variety of hypoxic modalities can be implemented to enhance adaptation to energy-systems and resistance-based training, and more efficiently return the athlete to competition readiness. While hypoxic modalities seem promising for accelerating musculoskeletal injury rehabilitation in humans, and are already being widely used in practice, a significant gap remains regarding their evidence-based application.
Click to expand...

NewsBot · Jun 24, 2025

Effect of blood flow restriction on muscle strength and stability following foot and ankle injury: A systematic review
Julia M Balboni et al
World J Orthop. 2025 Jun 18;16(6):106804.

Background: Poor musculoskeletal recovery following foot and ankle injury can result in chronic instability and persistent muscle weakness. Preliminary evidence has shown that blood flow restriction (BFR) rehabilitation can increase muscle strength and stability, helping to restore physical function and prevent repeated injury.

Aim: To determine whether BFR is more effective than traditional rehabilitation in improving muscle strength, size, and stability after foot and ankle injury.

Methods: A systematic review and meta-analysis were performed. Articles were retrieved from MEDLINE, EMBASE, and CENTRAL databases. Included studies compared the effectiveness of BFR rehabilitation to traditional foot and ankle rehabilitation exercises. Eligible patients were those with a history of foot or ankle injury. Muscle strength, size, and dynamic balance were assessed by comparing improvements in peak torque, cross-sectional area, and percent muscle activation. Methodological quality assessments were performed using the PEDro scale and Methodological Index for Non-Randomized Studies (MINORS).

Results: Ten studies met the inclusion criteria. Five studies were of good to excellent quality according to the PEDro scale, and 5 studies were of moderate quality as per the MINORS criteria. Two studies compared the effect of BFR and non-BFR rehabilitation on muscle strength; the overall mean difference between the BRF and non-BFR groups was 0.09 [95%CI: (0.05, 0.12), P < 0.0001]. Two studies analyzed muscle activation following BFR and non-BFR rehabilitation; the overall mean difference between the BRF and non-BFR groups was 0.09 [95%CI: (0.05, 0.12), P < 0.0001]. Data on dynamic balance was synthesized from two studies; the mean difference between the BFR and control groups was 1.23 [95%CI: (-1.55, 4.01); P = 0.39].

Conclusion: BFR rehabilitation is more effective than non-BFR rehabilitation at improving muscle strength and activation following foot and ankle injury. Additional studies are needed to develop a standardized BFR training protocol.
Click to expand...

NewsBot · Oct 28, 2025

How blood flow restriction resistance training has been studied on non-restricted muscles in healthy, injured and clinical populations: a scoping review and evidence gap map
Robert Trybulski et al
Source

Objectives Blood flow restriction (BFR) resistance training enhances muscle growth in restricted limbs, but its effects on non-restricted muscles remain unclear. This scoping review, accompanied by an evidence gap map, aims to systematically chart current literature on BFR’s impact on non-restricted muscles, summarise key outcomes and identify methodological trends to guide future research.

Methods Searches were conducted in PubMed, Scopus and Web of Science. Studies included adults—healthy or with musculoskeletal conditions—undergoing BFR resistance training, with passive or active comparator groups in two-arm or multi-arm designs. Data focused on chronic physiological (eg, muscle properties) and physical fitness (eg, strength, power) adaptations. Risk of bias was assessed using RoB 2 (Cochrane Risk of Bias 2 tool) for randomised and ROBINS-I (Risk of Bias in Non-Randomised Studies - of Interventions) for non-randomised studies.

Results From 1740 records, 19 studies (540 participants; 6 women) met the criteria. Intervention durations ranged from 2 to 12 weeks, with training frequencies of 2–6 sessions per week and cuff pressures of 50–270 mm Hg. The most reported outcomes were 1-repetition maximum strength, muscle cross-sectional area and thickness. The pectoralis major and shoulder rotators were the most frequently studied muscles. Most studies implemented BFR training two to three times weekly for an average of 8 weeks.

Conclusions Evidence suggests BFR training may benefit non-restricted muscles, but variability in study protocols, small sample sizes and limited standardisation hinder broad conclusions. Future research should employ consistent methodologies, larger cohorts and extended interventions to enhance comparability and generalisability.
Click to expand...

NewsBot · Dec 28, 2025

Chronic adaptations to blood flow restriction aerobic or bodyweight resistance training: A systematic review
Tulasiram Bommasamudram et al
Journal of Sports Sciences Volume 43, 2025

This systematic review aimed to examine the chronic adaptations of blood flow restriction (BFR) in conjunction with aerobic and bodyweight resistance training. A search of the electronic databases PubMed (MEDLINE), CINAHL, SPORTDiscus® (via EBSCOhost), Embase, and Cochrane (Central) was conducted to identify relevant published studies. The inclusion criteria encompassed a healthy adult sample population (>18 years), original studies, chronic exercise training interventions (minimum 2 weeks duration) employing aerobic BFR exercise or bodyweight resistance BFR exercise, and comparisons with equivalent intensity non-BFR aerobic or bodyweight resistance training. Thirty-three (n = 33) studies met the inclusion criteria and were included in the review. Among the included studies, chronic adaptations to BFR aerobic training were characterized by significant improvements in aerobic capacity (4–9%), muscle strength (6–31%), and muscle hypertrophy (2–11%) compared to non-BFR aerobic training. Furthermore, bodyweight resistance BFR training increased muscle hypertrophy (3–5%) and strength (4–11%). The findings suggest that both aerobic and bodyweight BFR training provide interchangeable options for practitioners prescribing BFR without access to a traditional equipment filled training environment, supporting flexibility in exercise programme design tailored to individual preferences, facility constraints, and specific fitness goals.
Click to expand...

NewsBot · Apr 22, 2026

The effects of high-pressure versus low-pressure blood flow restriction resistance exercise in individuals with lower limb musculoskeletal injuries and persistent pain: a randomised controlled trial
Luke Gray et al
Physical Therapy in Sport 17 April 2026, 101920

Highlights
•
High-pressure BFR may exacerbate injury-specific pain during rehabilitation.
•
Low-pressure BFR preserves training volume in those with MSKI and persistent pain.
•
A cumulative exercise-induced hypoalgesia effect (i.e., sustained increase in pressure pain threshold values) was present following repeated BFR sessions and at short-term (4 day) follow up.
•
High pressure may suit low-pain presentations or late-stage rehabilitation.
ABSTRACT
Objectives
Compare the efficacy and acceptability of low load blood flow restriction (BFR) using two different limb occlusion pressures (LOP) on pain and function in individuals with lower-limb musculoskeletal injury (MSKI) and associated persistent pain.
Design
Randomised controlled trial within a military residential rehabilitation setting.
Participants
Twenty-eight individuals (N=21 male; N=7 female) with lower-limb MSKI were randomly allocated into: 1) BFR-RE with 80% LOP (BFR80), or 2) BFR-RE with 40% LOP (BFR40). Both groups completed 7x BFR-RE sessions during 5-days of residential rehabilitation at 20% 1-repetition maximum.
Main Outcome Measures
The primary outcome measure was the Brief Pain Inventory (BPI). Secondary outcomes include injury-specific outcomes, pain pressure threshold (PPT) and lower-limb muscle strength assessment. All reported outcomes reflect changes in scores.
Results
BPI ‘worst’ displayed a time x group interaction (p=.013), driven by higher pain in BFR80 from pre- to post-intervention (standardised mean difference [SMD]=1.532, p=.006). There was a significant time x group interaction for BPI ‘severity’ (p=.022), driven by significant between-group differences at T3 (BFR80-BFR40: SMD=1.305, p=.015). PPTs improved within-session and over time.
Conclusion
Both pressures demonstrated cumulative exercise-induced hypoalgesia via rising PPTs. BFR80 reported increased ‘worst’ pain score. Lower LOP may better preserve training volume and exercise tolerability.
Click to expand...

NewsBot · May 10, 2026

Evaluating the effectiveness of blood flow restriction training in older adults: An overview of systematic reviews
Victor S. de Queiros et al
Source

Objective
To synthesize evidence from systematic reviews on the effects of blood flow restriction (BFR) training on muscle strength, hypertrophy, and functional performance in older adults.
Methods
An umbrella review was conducted after a comprehensive search in PubMed, Scopus, SPORTDiscus, and Web of Science until June 17, 2025. Eligible studies were systematic reviews, with or without meta-analyses, examining low-load BFR training in adults aged ≥ 50 years. Outcomes included muscle strength, hypertrophy, and physical function. Study selection and data extraction were performed independently by two reviewers, and methodological quality was assessed using AMSTAR 2.
Results
Twenty-three systematic reviews comprising 53 unique trials were included. Meta-analyses consistently indicated that BFR training promotes hypertrophy comparable to high-load resistance training (HL-RT) and superior to low-load training without BFR. Evidence on strength is mixed: some meta-analyses found gains similar to HL-RT, others reported inferior or superior results. Nevertheless, the majority of evidence suggests that BFR provides greater strength improvements compared to low-load training without BFR. Findings on functional performance were inconsistent. All reviews were rated as low or critically low in methodological quality. Across comparisons, heterogeneity and recurring methodological limitations-such as inadequate blinding and allocation concealment-were noted in primary studies.
Conclusion
BFR training is a promising approach to enhance muscle strength and hypertrophy in older adults, but evidence certainty is limited by methodological weaknesses in both trials and reviews. Well-designed, high-quality studies are needed to confirm these effects and support clinical implementation.
Click to expand...

NewsBot · Jun 6, 2026

Running with and without blood flow restriction on fatigability and biomechanics: a cross-over trial
Anh Phong Nguyen et al
Sports Biomechanics

Running assessments are frequently conducted without inducing fatigability because achieving true exhaustion in athletes can be both time consuming and physically demanding. Blood flow restriction (BFR) presents a potential solution by reducing time-to-exhaustion. To determine whether running with BFR (1) accelerates fatiguability compared to standard running and (2) influences running spatiotemporal parameters, including step frequency, step length, contact time, flight time, and duty factor. Sixteen participants (11 men, 5 women) completed two cross-over running trials until exhaustion under two conditions: control and 80% occlusion BFR. Time-to-exhaustion and heart rate were recorded as well as pre/post run maximal voluntary isometric contractions for knee flexors, knee extensors, and ankle plantar flexors. Running spatiotemporal parameters were measured at 65% of maximal aerobic speed both before and after exhaustive running. The BFR protocol significantly shortened time-to-exhaustion (7 min 51 s ±2 min 54 s vs. 24 min 02 s ±12 min 10 s in control, p < .001). Heart rate at exhaustion was lower in the BFR condition (169.5 ± 19.0 vs. 188.1 ± 8.9 bpm, p = .001). Post-run knee flexors strength declined similarly in both protocols (~21%), indicating comparable neuromuscular fatigability despite the shorter BFR running time. None of the spatiotemporal parameters differed significantly between conditions (p > .074). Running with BFR accelerates fatigability without significantly affecting running spatiotemporal parameters
Click to expand...

NewsBot · Jul 1, 2026

Blood flow restriction for chronic ankle instability: A meta-analysis of clinical and patient-reported outcomes
Caitlin Lightle et al
PM R. 2026 Jun 20. doi: 10.1002/pmrj.70172.

Objective: Blood flow restriction (BFR) has demonstrated beneficial effects by enabling muscle growth and strength with lighter weights, thereby reducing joint stress. BFR training has been studied in various joints such as after reconstruction of the anterior cruciate ligament, but its application in chronic ankle instability (CAI) remains underexplored. This systematic review aims to fill this gap by investigating the effects of BFR training on balance, ankle strength, and patient-reported outcomes in individuals with CAI.

Literature survey: A systematic search was conducted in PubMed, Scopus, CINAHL, and SPORTDiscus for randomized controlled trials published in English from 2000 onward. Studies were included if they examined BFR interventions in individuals with CAI. Methodological quality was assessed using the Physiotherapy Evidence Database scale.

Methodology: Two independent reviewers screened studies and extracted data. A random-effects meta-analysis synthesized outcomes related to balance, ankle strength, and self-reported instability.

Synthesis: Nine trials met inclusion criteria. Meta-analysis revealed significant improvements in balance (standardized mean difference [SMD] = 0.33-2.72), patient-reported outcomes (SMD = 0.04-2.84), and ankle strength (foot abduction SMD = 0.01-1.13; adduction SMD = 1.12-1.92). Substantial heterogeneity was observed, and most studies reported short-term effects.

Conclusions: BFR training may improve balance, ankle strength, and perceived stability in individuals with CAI. These findings support its potential as a rehabilitation adjunct, but high-quality trials are needed to confirm long-term efficacy and guide clinical implementation.
Click to expand...

NewsBot · Jul 2, 2026

Neuromuscular electrical stimulation with blood flow restriction shows preliminary effects on abductor hallucis muscle size and toe flexor strength: a pilot randomized controlled trial
Kazunori Okamura, Shoma Uehara, Naotaka Nagamune & Shusaku Kanai
European Journal of Applied Physiology

Purpose

To examine the effects of neuromuscular electrical stimulation (NMES) combined with blood flow restriction (BFR) on abductor hallucis (ABH) cross-sectional area (CSA) compared with NMES alone in a pilot randomized controlled trial. Toe flexor strength (TFS) and foot posture were also examined as secondary and exploratory outcomes, respectively.
Methods

Thirty participants were randomly allocated to either an NMES + BFR group or an NMES-alone group. Both groups received 15 min of ABH NMES three times weekly for 6 weeks, while the NMES + BFR group additionally received BFR. ABH CSA, TFS, and Foot Posture Index-6 (FPI-6) scores were assessed pre- and post-intervention by a blinded assessor. Post-intervention between-group differences were analyzed using baseline-adjusted analysis of covariance.
Results

The NMES + BFR group showed greater post-intervention ABH CSA than the NMES group (adjusted mean difference [95% confidence interval] = 0.19 [0.08–0.30] cm², p = 0.001). The between-group difference in TFS favored the NMES + BFR group but was not statistically significant (1.83 [− 0.09–3.75] kg, p = 0.061). Exploratory analysis showed lower post-intervention FPI-6 scores in the NMES + BFR group than in the NMES group (− 1.59 [− 2.46–−0.72] points, p = 0.001). No adverse events or intolerance leading to discontinuation occurred.
Conclusion

Six weeks of NMES combined with BFR showed preliminary favorable effects on ABH CSA compared with NMES alone, whereas evidence for superior improvement in TFS was inconclusive. All findings, including the exploratory foot posture results, require confirmation in larger studies with more complete intervention-dose reporting.
Click to expand...

NewsBot · Sep 11, 2026

Do Blood Flow Restriction Exercises Offer Additional Benefits when compared to Conventional Exercises in Musculoskeletal Rehabilitation?

NewsBot · Sep 27, 2026

Do blood flow restriction exercises offer additional benefits when compared to conventional exercises in musculoskeletal rehabilitation? A systematic review and meta-analysis
João V Ferlito et al
Source

Objectives This systematic review and meta-analysis evaluated the efficacy of low-load exercise with blood flow restriction (LLE-BFR) compared with low-load exercise (LLE) and high-load exercise (HLE) in individuals with musculoskeletal (MSK) conditions on muscle strength, disability and pain intensity.

Method Systematic review and meta-analysis of randomised clinical trials (RCTs). Methodological quality and risk of bias were assessed using the Physiotherapy Evidence Database (PEDro) scale and the Cochrane Risk of Bias 2 (RoB 2) tool.

Data source Six databases were searched without language restrictions from inception to November 2025, with additional studies identified from reference lists.

Eligibility criteria for selecting studies RCTs evaluating LLE-BFR versus LLE or HLE on muscle strength, pain intensity, disability and adverse events in people with MSK conditions.

Results We included 45 RCTs (1652 participants), with 44 RCTs (1607 participants) contributing to meta-analyses (mean PEDro score=6.55; most of the included trials were rated as ‘some concerns’ across one or more RoB 2 domains). Low-certainty evidence indicated LLE-BFR was superior to LLE for muscle strength (standardised mean difference (SMD)=0.82, 95% CI 0.40 to 1.23) and disability (SMD=0.63, 95% CI 0.36 to 0.89). Moderate-certainty evidence showed no clear difference between LLE-BFR and HLE for muscle strength (SMD=0.08, 95% CI −0.20 to 0.35), and very-low certainty evidence showed no clear difference for disability (SMD=0.66, 95% CI −0.16 to 1.47). Moderate- and low-certainty evidence indicated small, unimportant differences favouring LLE-BFR over LLE (MD=4.45, 95% CI 1.21 to 7.71) and HLE (MD=7.71, 95% CI 1.62 to 13.8) for pain intensity, respectively. Very-low and low-certainty evidence suggested no difference in adverse events between LLE-BFR and LLE (risk ratio, RR=0.92) or HLE (RR=1.08); however, adverse-event monitoring and reporting were inconsistent across trials.

Conclusion Low-certainty evidence indicates that LLE-BFR improves muscle strength and disability compared with LLE. Moderate-certainty evidence showed no clear difference in muscle strength compared with HLE, while evidence for disability was very low certainty, precluding firm conclusions. Prediction intervals were wide for several outcomes. Although pain reductions favoured LLE-BFR, these effects were small and unlikely to be clinically meaningful, and evidence regarding adverse events remains limited.
Click to expand...

Blood flow restriction (occlusion) training

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Blood Flow in Patients with Plantar Heel Pain

Acute effects of warming up on Achilles tendon blood flow and stiffness

Foot skin temperature and blood flow in type 2 diabetes

Passive Hallux Adduction Decreases Blood Flow to Plantar Fascia

Acute Effect of Running Exercise on Physiological Achilles Tendon Blood Flow

Overpronation and achilles tendon blood flow

Exercises to Improve Blood Flow in your Feet

Share This Page

Blood flow restriction (occlusion) training

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Blood Flow in Patients with Plantar Heel Pain

Acute effects of warming up on Achilles tendon blood flow and stiffness

Foot skin temperature and blood flow in type 2 diabetes

Passive Hallux Adduction Decreases Blood Flow to Plantar Fascia

Acute Effect of Running Exercise on Physiological Achilles Tendon Blood Flow

Overpronation and achilles tendon blood flow

Exercises to Improve Blood Flow in your Feet

Share This Page

Useful Searches