BACKGROUND & OBJECTIVE
Traditional resistance training guidelines recommend loads greater than 65% of the 1-repetition maximum (RM) to improve muscle mass and strength. However, many clinical populations are unable to tolerate heavier loading, making them susceptible to muscle atrophy, strength loss and functional impairment. Blood flow restriction (BFR) therapy has been shown to produce similar muscle mass and strength gains as heavier loading programs with less than 30% 1RM. The purpose of this meta-analysis and systematic review was to examine the efficacy of low-load BFR training on clinical musculoskeletal populations, focusing on BFR safety and applications to provide recommendations on best practice.
A standardized search procedure identified 20 studies that met eligibility for the systematic review and 13 for the meta-analysis, for a total of 33 included studies. Only randomized-controlled trials comparing low-load BFR training to either low-load or high-load protocol without BFR were included in the meta-analysis. Eight studies compared low-load BFR to low-load training while five compared low-load BFR to high-load training. The studies within the systematic review portion each had between 10-41 participants per study with an average age of 58 ± 14 years old. Each study in the systematic review was appraised for study quality (including bias) and reporting using the TESTEX tool.
The meta-analysis revealed that BFR augments muscle mass and strength gains in clinical populations. Results show that the addition of BFR to low-loading programs is superior to low-loading alone. Statistical analysis showed that 69% of the population would experience greater