Review of the Chronic Effects of Blood Flow Restriction Training Programs on Athletes

Review of the Chronic Effects of Blood Flow Restriction Training Programs on Athletes

Blood flow restriction (BFR) training has gained significant attention in recent years as a method to enhance athletic performance. By limiting blood flow through a combination of venous occlusion and arterial restriction, BFR induces metabolic stress that stimulates several physiological adaptations. Despite its growing use, the most effective applications and implementation strategies remain unclear. Purpose: This review examines the chronic effects of BFR training on aerobic and anaerobic performance measures in athletes in an attempt to clarify the efficacy and sport-specific applications of BFR training, providing a foundation for optimized implementation in high-performance settings. Methods: The online databases Google Scholar, PubMed, and EBSCO were utilized, with search terms including "Blood Flow Restriction Training," "BFR," and "Occlusion Training." Inclusion criteria consisted of peer-reviewed studies published in English with sample populations of athletes or competitive, highly-trained individuals. Findings were synthesized using thematic analysis by mode of action and refined into individual categories. Results: Findings suggest both muscle hypertrophy and strength improvements of approximately 4-12% and 8-14%, respectively. This is theorized to be due primarily to cell swelling and metabolic stress. Findings further suggest that BFR is able to achieve or amplify these outcomes with lower loads, whereas normal resistance training typically requires higher loading to achieve the same metabolic stresses. Additionally, BFR may have aerobic performance outcomes impacting aerobic power via improvements in VO2 max and muscle deoxygenation attenuation. Adaptations in VO2 max varied greatly, from non-significant to 9.1% improvements. Conclusion: Findings suggest that elite athletes, despite being highly conditioned, exhibit significant physiological adaptations in response to BFR. Current research features a glaring lack of standardization in the magnitudes of cuff pressure settings used in training interventions, with studies employing set pressures, percentage-based systems, or even graded pressures. Further research should be conducted to develop optimal pressure guidelines for these populations.