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July 1, 2026Annals of MedicineOpen Access

Blood flow restriction plus resistance training significantly enhances lower-limb muscle strength versus control training.

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Why the study?

Athletes and coaches continuously explore strategies to reduce training load and injury risk while increasing muscular strength and sport-specific performance.

Does blood flow restriction training combined with resistance training improve lower-limb muscle strength and sport-specific performance in athletes?

Comparison

BFRT combined with RT vs control training

Design

Systematic review and meta-analysis of RCTs

Key result

Blood flow restriction training combined with resistance training significantly enhanced lower-limb muscle strength (SMD 1.09; 95% CI 0.52-1.66; p<0.05) compared to control training.

Authors

QXQingyu XuYWYancong WangDMDan Ma

Discussion

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Overview

BFRT plus RT may enhance athlete lower-limb strength; reinforces pooled RCT evidence for training protocols.

Key Points

  • This review aims to assess the impact of blood flow restriction training combined with resistance training on lower-limb muscle strength and sport-specific performance in athletes.
  • Systematic search for relevant randomized controlled trials across major databases until November 2024.
  • Inclusion of ten RCTs involving 181 athletes, with 91 in the intervention group and 90 in the control group.
  • Data analysis employed RevMan 5.4 for meta-analysis and heterogeneity testing.
  • BFRT combined with RT led to significant improvements in lower-limb muscle strength (SMD = 1.09, 95% CI [0.52, 1.66], p < 0.05).
  • Significant hypertrophy was observed (MD = 1.09, 95% CI [0.10, 2.09], p < 0.05) compared to control training.
  • No significant difference in sport-specific performance was reported (SMD = 0.11, 95% CI [−0.18, 0.40], p = 0.46).

Study Design

Type

Meta-Analysis (n=181)

Structured PICO

Does blood flow restriction training combined with resistance training improve lower-limb muscle strength and sport-specific performance in athletes?

P
Population
181 athletes from 10 randomized controlled trials evaluating blood flow restriction training combined with resistance training.
I
Intervention
Blood flow restriction training (BFRT) combined with resistance training (RT)
C
Comparator
Control training (RT or conventional training alone)
O
Outcome
Lower-limb muscle strength and sport-specific performancesurrogate

Main Result

Standardized Mean Difference: 1.09 (95% CI 0.52–1.66)

p-value: p=< 0.05

BFRT combined with resistance training improves lower-limb muscle strength and hypertrophy in athletes, though it does not directly enhance sport-specific performance.

Limitations

  • Substantial heterogeneity was observed for strength outcomes (I2 = 75%)

Cite This Study

Xu et al. (2026) conducted a meta-analysis in athletes (n=181). Blood flow restriction training (BFRT) combined with resistance training (RT) vs. control training was evaluated on lower-limb muscle strength (SMD 1.09, 95% CI 0.52, 1.66, p=< 0.05). Blood flow restriction training combined with resistance training significantly enhanced lower-limb muscle strength (SMD 1.09; 95% CI 0.52-1.66; p<0.05) compared to control training.

synapsesocial.com/papers/6a44add75cd2549c8bc433f0https://doi.org/10.1080/07853890.2026.2658885
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