The effect of blood flow restricted exercise on measures of health and physical fitness across all populations: An umbrella review and meta-meta-analysis
Date
2025
Authors
Oborn, C.
Nelson, M.J.
Davison, K.
Murray, J.
Green, K.
Shahid, J.
Bennett, H.
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Journal article
Citation
Sports Medicine and Health Science, online, 2025; online(6):1-13
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Abstract
Purpose: To consolidate and evaluate meta-analyses reporting the effects of blood flow restricted exercise (BFRE) on measures of health and physical fitness across all populations.
Methods: This preregistered umbrella review followed PRISMA guidelines. A comprehensive search of five databases identified meta-analyses evaluating the effects of BFRE interventions (aerobic, resistance, combined) compared to exercising and non-exercising control conditions on measures of health and performance. A multilevel meta-analysis of standardised mean differences (SMDs) was conducted to examine the effects of BFRE. Subgroup analyses were conducted for the participant and intervention characteristics. Risk of bias was assessed using the AMSTAR-2.
Results: 47 meta-analyses comprised of 265 unique studies were included. All reviews were rated as low-moderate quality. BFRE had a small effect on hypertrophy (SMD = 0.39, p < 0.001) and a moderate effect on strength (SMD = 0.61, p < 0.001) when compared to low load, but not high load resistance training (hypertrophy, SMD = −0.13, p = 0.142; strength, SMD = -0.28, p < 0.001). BFRE had small-to-moderate effects on aerobic fitness (SMD = 0.50, p < 0.001), vascular health (SMD = 0.45, p < 0.001), blood pressure (SMD = 0.46, p < 0.001), and muscular power (SMD = 0.56, p < 0.001). BFRE had no effect on physical function (SMD = 0.16, p = 0.096), pain (SMD = 0.00, p = 0.996), and speed (SMD = 0.22, p = 0.213).
Conclusions: BFRE is a viable option to improve hypertrophy, strength, aerobic fitness, and vascular health across various populations, though its effects on hypertrophy and strength are smaller when compared to traditional high load resistance training. It doesn't appear to offer any additional benefits than other training methods for physical function, pain, or speed, although sub-analyses suggest further research is warranted in select areas of application.
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Data source: supplementary data, https://doi.org/10.1016/j.smhs.2025.02.011
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Copyright 2025 Chengdu Sport University. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Access Condition Notes: This is an open access article under the CC BY-NC-ND license