Comparing adaptations from blood flow restriction exercise training using regulated or unregulated pressure systems: a systematic review and meta-analysis

Review written by Dr Nicholas Rolnick info

Key Points

  1. The study aimed to compare chronic adaptations to blood flow restriction (BFR) training using autoregulated versus unregulated pressure systems, focusing on outcomes like muscle size, strength, and physical function.
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BACKGROUND & OBJECTIVE

Autoregulation is a possible device feature of blood flow restriction (BFR) cuffs. When a cuff is said to “autoregulate,” or be “regulated,” the cuff is supposed to adjust the amount of applied pressure to the exercising limb to maintain a consistent interface pressure (e.g. the pressure applied from the cuff to the limb) (1).

Other cuffs without the capacity to regulate may expose exercisers to higher than desired interface pressures as the muscles underneath the cuff bunch up and increase the pressure from the limb to the BFR cuff. As such, it has been proposed that autoregulation increases the safety and tolerability of BFR exercise (2).

However, despite the presence of many different cuffs having an autoregulation feature, no study has attempted to discern if the longitudinal outcomes associated with BFR training are different between cuffs that can and cannot regulate. Therefore, this study aimed to answer this question.

Autoregulation is a possible device feature of blood flow restriction (BFR) cuffs. It has been proposed that autoregulation increases the safety and tolerability of BFR exercise.
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Existing research indicates that outcomes related to muscle strength, muscle size, and physical function can be comparable regardless of whether the cuff has autoregulation capability.

METHODS

Clarkson et al. (2024) examined regulated versus unregulated BFR systems based on a diverse body of literature (n = 81 studies), including studies employing various cuff widths (ranging from 2.5 to 20.5 cm) and pressure applications (71 to 350 mmHg).

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