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The effects of low-load blood flow restriction training versus high-intensity resistance training on muscle strength, hypertrophy, and endurance in athletes: a systematic review and meta-analysis

kinesiology
sports-medicine

Abstract

Background. Traditional high-intensity resistance training is a common method for enhancing muscle strength, endurance, and hypertrophy. However, athletes in post-operative or pre-competition recovery phases may experience reduced tolerance, increasing injury risk. Low-intensity blood flow restriction training induces similar muscle adaptation responses and is therefore considered more suitable for such populations. To clarify the differences in training efficacy between the two approaches, a systematic comparison of the effects of low-intensity blood flow restriction training versus traditional high-intensity resistance training in athletic populations is urgently required.
Methodology. A search was conducted of the PubMed, Web of Science and Google Scholar databases from 2011 to the present. Using Revman 5.4 software to analyse differences in mean values, with a 95% confidence interval.
Results. The meta-analysis included 12 articles involving 129 athletes. Results indicate no significant difference between the two training methods in enhancing muscle strength; however, a significant difference exists in promoting muscle hypertrophy (P < 0.01), with the heterogeneity test yielding P = 0.06 and I² = 45%. SMD = 0.97 [0.69, 1.26]; a significant difference was observed in muscle endurance (P < 0.01), with the heterogeneity test yielding P = 0.57, I² = 0%; SMD = 0.77 [0.34, 1.20]. In the comparative analysis of training cycles, L-BFRT demonstrated superior short-term adaptive effects during the 2- to 4-week phase. Within the first two weeks, MVC and TW increased by 18.1% and 18.7% respectively, markedly exceeding the HRT group's gains (MVC: 7.5%; TW: 8.57%). Regarding muscle hypertrophy (MH), L-BFRT achieved a 7.5% increase by week 4, outperforming the HRT group's 2.7%. However, as the training cycle extended, HRT progressively surpassed L-BFRT in MVC gains, reaching 27.5% by week 8 compared to L-BFRT's 19.3% increase over the same period.
Conclusions. L-BFRT demonstrates superiority over HRT in enhancing muscle hypertrophy and endurance within the short term, whereas HRT exhibits greater advantages in long-term strength gains. The selection between the two approaches should be guided by the training cycle and specific objectives.
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