Abstract
Objective
To analyze the effectiveness of the blood flow restriction training in improving muscle
strength and physical performance in older adults.
Data Sources
A systematic review and meta-analysis of randomized controlled trials was conducted.
The Cochrane Library, PubMed, Web of Sciences, PEDro, Scopus, and ScienceDirect databases
were systematically searched.
Study Selection
Articles were included if participants were 60 years or older and were considered
healthy.
Data Extraction
The search strategy found a total of 363 studies. Finally, 10 articles were included
in the systematic review, with a total of 278 healthy older adults analyzed.
Data Synthesis
The main results of the meta-analysis showed a statistical difference of muscle strength
in favor of blood flow restriction training when compared with conventional training
and no statistical differences when compared with high-intensity resistance training.
Physical performance showed a nonstatistical difference between the blood flow restriction
training, conventional training, and no training groups.
Conclusions
Blood flow restriction training is an interesting alternative to high-intensity strength
training for improving muscle strength in older individuals who cannot perform high-load
exercises.
Keywords
List of abbreviations:
1RM (1 repetition maximum), BFR (blood flow restriction), BFRt (blood flow restriction training), BFRw (blood flow restriction walking), CI (confidence interval), HIRT (high-intensity resistance training), IRR (interrater reliability), LIRT (low-intensity resistance training), PEDro (Physiotherapy Evidence Database), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), RoB 2 (Risk of Bias 2 tool), SMD (standard mean difference)To read this article in full you will need to make a payment
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References
- Functional ability, frailty and risk of falls in the elderly: relations with autonomy in daily living.Int J Environ Res Public Health. 2020; 17: 1006
- Frailty consensus: a call to action.J Am Med Dir Assoc. 2013; 14: 392-397
- Frailty in the clinical scenario.Lancet. 2015; 385: e7-e9
- Sarcopenia: revised European consensus on definition and diagnosis.Age Ageing. 2019; 48: 16-31
- Strength and endurance training prescription in healthy and frail elderly.Aging Dis. 2014; 5: 183-195
- Effectiveness of protein supplementation combined with resistance training on muscle strength and physical performance in elderly: a systematic review and meta-analysis.Nutrients. 2020; 12: 2607
- Resistance training for older adults: position statement from the National Strength and Conditioning Association.J Strength Cond Res. 2019; 33: 2019-2052
- International exercise recommendations in older adults (ICFSR): expert consensus guidelines.J Nutr Heal Aging. 2021; 25: 824-853
- Physical strategies to prevent disuse-induced functional decline in the elderly.Ageing Res Rev. 2018; 47: 80-88
- Exercise interventions for the prevention and treatment of sarcopenia. A systematic umbrella review.J Nutr Health Aging. 2019; 23: 494-502
- Blood flow restriction therapy: from development to applications.Sports Med Arthrosc Rev. 2019; 27: 119-123
- Low intensity blood flow restriction training: a meta-analysis.Eur J Appl Physiol. 2012; 112: 1849-1859
- Blood flow restriction exercise position stand: considerations of methodology, application, and safety.Front Physiol. 2019; 10: 533
- Potential safety issues with blood flow restriction training.Scand J Med Sci Sport. 2011; 21: 510-518
- Mechanisms of blood flow restriction: the new testament.Tech Orthop. 2018; 33: 72-79
- Blood flow restriction therapy.J Am Acad Orthop Surg. 2020; 28: e493-e500
- Blood flow restriction: methods matter.Exp Gerontol. 2018; 104: 7-8
- A mechanistic approach to blood flow occlusion.Int J Sports Med. 2010; 31: 1-4
- A review on the mechanisms of blood-flow restriction resistance training-induced muscle hypertrophy.Sport Med. 2015; 45: 187-200
- Blood flow restriction: how does it work?.Front Physiol. 2012; 3: 392
- Magnitude of muscle strength and mass adaptations between high-load resistance training versus low-load resistance training associated with blood-flow restriction: a systematic review and meta-analysis.Sport Med. 2018; 48: 361-378
- Effect of blood-flow restricted vs heavy-load strength training on muscle strength: systematic review and meta-analysis.Scand J Med Sci Sport. 2020; 30: 837-848
- Effects of blood flow restriction training on aerobic capacity and performance.J Strength Cond Res. 2019; 33: 572-583
- The efficacy of blood flow restricted exercise: a systematic review & meta-analysis.J Sci Med Sport. 2016; 19: 669-675
- Blood flow restriction training in rehabilitation following anterior cruciate ligament reconstructive surgery: a review.Tech Orthop. 2018; 33: 106-113
- Comparing the effectiveness of blood flow restriction and traditional heavy load resistance training in the post-surgery rehabilitation of anterior cruciate ligament reconstruction patients: a UK National Health Service randomised controlled trial.Sport Med. 2019; 49: 1787-1805
- Blood flow restriction training in patients with knee osteoarthritis: systematic review of randomized controlled trials.J Bodyw Mov Ther. 2021; 27: 477-486
- Comparison of blood flow restriction training versus non-occlusive training in patients with anterior cruciate ligament reconstruction or knee osteoarthritis: a systematic review.J Clin Med. 2020; 10: 68
- Effects of blood flow restriction training on muscular strength and hypertrophy in older individuals: a systematic review and meta-analysis.Sport Med. 2019; 49: 95-108
- Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.PLoS Med. 2009; 6e1000097
- Effects of exercise interventions on the functional status of acutely hospitalised older adults: a systematic review and meta-analysis.Ageing Res Rev. 2020; 61101076
- Frailty and physical fitness in elderly people: a systematic review and meta-analysis.Sport Med. 2021; 51: 143-160
- Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies.J Diabetes Metab Disord. 2017; 16: 21
- Is power training effective to produce muscle hypertrophy in older adults? A systematic review and meta-analysis.Appl Physiol Nutr Metab. 2020; 45: 1031-1040
- Cochrane handbook for systematic reviews of interventions.2nd. John Wiley & Sons, Chichester, UK2019
- The measurement of observer agreement for categorical data.Biometrics. 1977; 33: 159-174
- RoB 2: a revised tool for assessing risk of bias in randomised trials.BMJ. 2019; 366: I4898
- Reliability of the PEDro scale for rating quality of randomized controlled trials.Phys Ther. 2003; 83: 713-721
- Agreement between the Cochrane risk of bias tool and Physiotherapy Evidence Database (PEDro) scale: a meta-epidemiological study of randomized controlled trials of physical therapy interventions.PLoS One. 2019; 14e0222770
- The revised Cochrane risk of bias tool for randomized trials (RoB 2) showed low interrater reliability and challenges in its application.J Clin Epidemiol. 2020; 126: 37-44
- Meta-analysis in clinical trials.Control Clin Trials. 1986; 7: 177-188
- Measuring inconsistency in meta-analyses.BMJ. 2003; 327: 557-560
- Effect of 16 weeks of resistance exercise and detraining comparing two methods of blood flow restriction in muscle strength of healthy older women: a randomized controlled trial.Exp Gerontol. 2018; 114: 78-86
- Low-load resistance training and blood flow restriction improves strength, muscle mass and functional performance in postmenopausal women: a controlled randomized trial.Int Phys Med Rehabil J. 2019; 4: 63-68
- Effect of concurrent training with blood flow restriction in the elderly.Int J Sports Med. 2015; 36: 395-399
- Effects of detraining after blood flow-restricted low-intensity training on muscle size and strength in older adults.Aging Clin Exp Res. 2014; 26: 561-564
- Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly.J Strength Cond Res. 2015; 29: 1071-1076
- Muscle size and arterial stiffness after blood flow-restricted low-intensity resistance training in older adults.Scand J Med Sci Sport. 2014; 24: 799-806
- Effects of low-intensity resistance exercise with vascular occlusion on physical function in healthy elderly people.Biosci Trends. 2008; 2: 117-123
- Blood flow restricted resistance training in older adults at risk of mobility limitations.Exp Gerontol. 2017; 99: 138-145
- Blood-flow restricted resistance training in patients with sporadic inclusion body myositis: a randomized controlled trial.Scand J Rheumatol. 2018; 47: 400-409
- Clinimetrics: Physiotherapy Evidence Database (PEDro) scale.J Physiother. 2020; 66: 59
- Blood flow restriction walking and physical function in older adults: A randomized control trial.J Sci Med Sport. 2017; 20: 1041-1046
- Does blood flow restriction therapy in patients older than age 50 result in muscle hypertrophy, increased strength, or greater physical function? A systematic review.Clin Orthop Relat Res. 2020; 478: 593-606
- Effects of blood flow restriction training on strength, muscle mass and physical function in older individuals - systematic review and meta-analysis.Phys Occup Ther Geriatr. 2020; 38: 400-417
- Progression models in resistance training for healthy adults.Med Sci Sport Exerc. 2009; 41: 687-708
- Blood flow restriction training as a prehabilitation concept in total knee arthroplasty: a narrative review about current preoperative interventions and the potential impact of BFR.Med Hypotheses. 2018; 110: 53-59
- The role of blood flow restriction training to mitigate.Tech Orthop. 2018; 33: 98-105
- Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis.Br J Sports Med. 2017; 51: 1003-1011
- The safety of blood flow restriction training as a therapeutic intervention for patients with musculoskeletal disorders: a systematic review.Am J Sports Med. 2020; 48: 1773-1785
Article info
Publication history
Published online: January 10, 2022
Accepted:
December 16,
2021
Received in revised form:
December 3,
2021
Received:
July 7,
2021
Footnotes
Clinical Trial Register No. (PROSPERO): CRD42020186828
Disclosures: none.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
