Remote coaching with blood flow restriction training: impact on strength, body composition, metabolism, and walking energetics in overweight adults

PURPOSE: Blood flow restriction (BFR) is a widely used exercise modality in sport; however, evidence supporting its use in individuals with overweight remains limited. This study evaluated whether home-based BFR training provides additional benefits over conventional resistance training in this population. METHODS: Twenty-seven participants were assigned to BFR (n = 13) or non-BFR (n = 14) groups for a 6-week (3x/week) home-based strength program via videoconference. Assessments included body composition (DEXA), glucose and lipid metabolism, knee extensor/flexor strength, and gait analysis (energetics, biomechanics and preferred walking speed). RESULTS: No group × time interactions were observed for any outcome, indicating no BFR-induced benefits. Across both groups, trunk lean mass increased (BFR: 27.2 ± 4.3 to 27.9 ± 4.5 kg; non-BFR: 25.4 ± 4.0 to 25.8 ± 4.4 kg; P = 0.007). HDL-cholesterol decreased (P = 0.008) and glycated haemoglobin increased (P < 0.001), both statistically significant but clinically negligible and directionally unfavourable. Isometric knee-extension peak torque increased (BFR: 186 ± 50 to 222 ± 80 Nm; non-BFR: 183 ± 81 to 204 ± 90 Nm; P < 0.001), with parallel gains in isokinetic concentric extension and flexion at 30°/s, 90°/s, and 180°/s (all P ≤ 0.032). Gait analysis showed no changes. CONCLUSION: Six weeks of remotely supervised bodyweight resistance training improved knee extensor and flexor strength in sedentary adults with overweight or obesity. Under the present conditions, adding BFR did not provide evidence of additional benefit for strength, body composition, metabolic markers, or walking outcomes. TRIAL REGISTRATION: The trial was registered in advance at ClinicalTrials.gov with the identifier NCT05371119 on 12 May 2022.