Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis

Background: Although blood flow restriction (BFR) training has been increasingly investigated for its potential to enhance aerobic capacity and performance in endurance athletes, its overall effectiveness remains inconclusive. This systematic review and meta-analysis aimed to evaluate the impact of...

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Main Authors: ZekaiZhang, Zhang, XuejiaoGao, Gao, LangGao, Gao
Format: Article
Language:English
Published: BioMed Central 2025
Online Access:http://psasir.upm.edu.my/id/eprint/120148/
http://psasir.upm.edu.my/id/eprint/120148/1/120148.pdf
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author ZekaiZhang, Zhang
XuejiaoGao, Gao
LangGao, Gao
author_facet ZekaiZhang, Zhang
XuejiaoGao, Gao
LangGao, Gao
author_sort ZekaiZhang, Zhang
building UPM Institutional Repository
collection Online Access
description Background: Although blood flow restriction (BFR) training has been increasingly investigated for its potential to enhance aerobic capacity and performance in endurance athletes, its overall effectiveness remains inconclusive. This systematic review and meta-analysis aimed to evaluate the impact of BFR training on aerobic capacity, muscle strength, and endurance performance in endurance athletes compared to the same training without BFR. Methodology: Databases searched included PubMed, Scopus, Web of Science, and SPORTDiscus through September 2024. The methodological quality of the included studies was assessed using the PEDro tool, with meta-analyses conducted using the R program. Results: A total of 20 studies, involving 407 subjects, were included in the meta-analysis. The results revealed that BFR training had moderate effects on improving VO2max (ES = 0.465, 95% CI [0.222, 0.707], P < 0.001)) and endurance performance (ES = 0.693, 95% CI [0.252, 1.135], P < 0.01). Additionally, it demonstrated a large effect on maximal strength (ES = 1.022, 95% CI [0.267, 1.778], P < 0.01) and a small effect on aerobic power (ES = 0.315, 95% CI [0.015, 0.616], P < 0.05). Furthermore, subgroup analyses showed that age, athlete level, training duration, frequency, type, and cuff pressure did not significantly moderate the effectiveness of BFR training. Conclusions: BFR training significantly enhances aerobic capacity, muscle strength, and overall performance in endurance athletes compared to similar training without BFR. This approach provides a practical strategy for improving endurance and strength, especially during periods when high-intensity training is less feasible, such as recovery phases or in-season maintenance. The prospero registration number: CRD42024581910.
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spelling upm-1201482025-09-24T02:00:58Z http://psasir.upm.edu.my/id/eprint/120148/ Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis ZekaiZhang, Zhang XuejiaoGao, Gao LangGao, Gao Background: Although blood flow restriction (BFR) training has been increasingly investigated for its potential to enhance aerobic capacity and performance in endurance athletes, its overall effectiveness remains inconclusive. This systematic review and meta-analysis aimed to evaluate the impact of BFR training on aerobic capacity, muscle strength, and endurance performance in endurance athletes compared to the same training without BFR. Methodology: Databases searched included PubMed, Scopus, Web of Science, and SPORTDiscus through September 2024. The methodological quality of the included studies was assessed using the PEDro tool, with meta-analyses conducted using the R program. Results: A total of 20 studies, involving 407 subjects, were included in the meta-analysis. The results revealed that BFR training had moderate effects on improving VO2max (ES = 0.465, 95% CI [0.222, 0.707], P < 0.001)) and endurance performance (ES = 0.693, 95% CI [0.252, 1.135], P < 0.01). Additionally, it demonstrated a large effect on maximal strength (ES = 1.022, 95% CI [0.267, 1.778], P < 0.01) and a small effect on aerobic power (ES = 0.315, 95% CI [0.015, 0.616], P < 0.05). Furthermore, subgroup analyses showed that age, athlete level, training duration, frequency, type, and cuff pressure did not significantly moderate the effectiveness of BFR training. Conclusions: BFR training significantly enhances aerobic capacity, muscle strength, and overall performance in endurance athletes compared to similar training without BFR. This approach provides a practical strategy for improving endurance and strength, especially during periods when high-intensity training is less feasible, such as recovery phases or in-season maintenance. The prospero registration number: CRD42024581910. BioMed Central 2025 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/120148/1/120148.pdf ZekaiZhang, Zhang and XuejiaoGao, Gao and LangGao, Gao (2025) Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation, 17 (1). art. no. 160. pp. 1-10. ISSN 2052-1847 https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-025-01194-3 10.1186/s13102-025-01194-3
spellingShingle ZekaiZhang, Zhang
XuejiaoGao, Gao
LangGao, Gao
Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title_full Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title_fullStr Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title_full_unstemmed Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title_short Effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
title_sort effects of blood flow restriction training on aerobic capacity and performance in endurance athletes: a systematic review and meta-analysis
url http://psasir.upm.edu.my/id/eprint/120148/
http://psasir.upm.edu.my/id/eprint/120148/
http://psasir.upm.edu.my/id/eprint/120148/
http://psasir.upm.edu.my/id/eprint/120148/1/120148.pdf