Objectives: The purpose of this study was to investigate the effectiveness of BFR training protocols relative to other forms of training on muscle strength, hypertrophy and endurance.
Data Sources: Systematic searches of Medline, Embase, PubMed were performed using relevant search terms. Methodological quality of included studies was assessed using the Cochrane risk of bias tool.
Main Results: 53 randomized controlled trials were included in the review with 31 included in meta-analyses. For muscular strength comparing low-intensity BFR (LIBFR) training to high-intensity resistance training (HIRT), pooled mean difference (MD) for 1 repetition maximum was 5.34 kg (95% CI: 2.58 – 8.09, p < 0.01) favoring HIRT. When comparing LI-BFR training to HIRT for torque, MD was 6.35 Nm (95% CI: 0.5 – 12.3, p = 0.04) also favoring HIRT. However, comparing LI-BFR to low-intensity resistance training (LIRT) for torque there was a MD of 9.94 Nm (95% CI: 5.43 – 14.45, p < 0.01) favoring BFR training. Assessing muscle hypertrophy, the overall MD in cross-sectional area (CSA) was 0.96 cm2 (95% CI: 0.21 - 1.7, p = 0.01) favoring pooled BFR training protocols compared to non-occlusive training protocols. For assessment of endurance, VO2 Maximum demonstrated a greater mean increase of 0.37 mL/kg/min (95% CI: -0.97 - 3.17, p =0.64) in BFR endurance training compared to endurance training alone.
BFR training has demonstrated potential for increasing muscular strength, hypertrophy and endurance. Comparing LI-BFR training to HIRT, HIRT was a significantly better training modality for increasing muscle hypertrophy and strength. However, LI-BFR was superior when compared to a similar low-intensity protocols.