Blood Flow Restriction Therapy for Athletes: A Systematic Review

Abstract

Blood Flow Restriction (BFR) is a novel technique involving the use of a cuff/tourniquet system positioned around the proximal end of an extremity in order to maintain arterial flow, while restricting venous return. The purpose of this systematic review was to analyze the available literature regarding the use of BFR to supplement traditional resistance training in healthy athletes. A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From November – December 2018, studies that examined the effects of BFR training in athletes were identified using PubMed and OVID Medline. Reference lists from selected articles were analyzed for additional studies. The inclusion criteria for full text-review were randomized studies with control groups that implemented BFR training into athletes’ resistance training workouts. Case reports and review studies were excluded. The following data was extracted: patient demographics, study design, training protocol, occlusive cuff location/pressure, maximum strength improvements, muscle size measurements, markers of sport performance (e.g. sprint time, agility tests and jump measurements), and other study specific markers (e.g. electromyography, muscular torque, and muscular endurance). The initial search identified 237 articles. After removing duplicates and screening titles, abstracts, and full text, ten studies were identified that met the inclusion criteria. Seven of nine (78%) studies found a significant increase in strength associated with use of BFR training compared to control groups; four of eight (50%) found significant increases in muscle size associated with BFR therapy; three of four (75%) reported significant improvements in sport specific measurements in the groups that used BFR training. Occlusive cuff pressure varied across studies from 110-240 mmHG. This study demonstrates that BFR is effective at improving strength, muscle size, and markers of sports performance in healthy athletes. Combining traditional resistance training with BFR may allow athletes to maximize athletic performance and remain in good health. Additional studies should be conducted to find an optimal occlusive pressure to maximize training improvements.