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SYSTEMATIC REVIEW article

Front. Physiol.

Sec. Exercise Physiology

Volume 16 - 2025 | doi: 10.3389/fphys.2025.1587876

This article is part of the Research Topic Impact of Blood Flow Restriction Device Features and Methodological Considerations on Acute- and Longitudinal Responses to Blood Flow Restricted Exercise View all 10 articles

Effect of different blood flow restriction training regimens combined with low-intensity training on muscle strength and cardiovascular safety in older adults: a systematic review and network meta-analysis

Provisionally accepted
Meiling Ren Meiling Ren Guangshen Xian Guangshen Xian Xiangchao Tan Xiangchao Tan Shaocheng Sun Shaocheng Sun Ming Zhang Ming Zhang *
  • Beijing Sport University, Beijing, China

The final, formatted version of the article will be published soon.

    Older adults are experiencing a gradual decline in physical function as they age. Previous studies have shown that blood flow restriction (BFR) combined with low-intensity training can improve muscle strength and maintain cardiovascular fitness in older adults. However, it remains unclear which training regimen is the most effective. This study aims to investigate the effects of different BFR regimens combined with low-intensity training on muscle strength and cardiovascular safety in older adults. PubMed, Web of Science, Embase, the Cochrane Library, Scopus, EBSCOhost, and CNKI were searched up to March 2025 to select eligible studies. The randomized controlled trials that explored the effects of BFR training on muscle strength and cardiovascular safety in older adults were included. A total of 18 studies with 626 participants were included. The results of this network meta-analysis showed that: (1) in terms of improving muscle strength: compared to the controls, low-frequency, low-pressure, and low-intensity BFR training regimen was significantly related to one-repetition maximum (1RM) strength [weighted mean difference (WMD) = 1.26, 95% confidence interval (CI) (0.01, 2.50) P< 0.05]. Moreover, high-frequency, high-pressure, and low-intensity BFR training was associated with increased muscle cross-sectional area [WMD=0.50,95% CI (-0.10,1.11), P>0.05] and isometric muscle strength [WMD=1.44,95% CI (0.75,2.12), P<0.05]; (2) in terms of cardiovascular health: compared to the controls, BFR training regimens at different pressures and frequencies were not linked to changes in heart rate in older adults (P>0.05). Moreover, low-frequency, low-pressure, and low intensity BFR training regimen was associated with increased systolic blood pressure [WMD=3.40, 95%CI (0.61,6.19), P<0.05] and diastolic blood pressure [WMD=13. 40, 95%CI (8.96,17.84), P<0.05] in older adults. Based on the results, high-frequency, high-pressure, and low-intensity BFR training may serve as the optimal regimen to improve muscle strength and maintain cardiovascular fitness in older adults.

    Keywords: Blood flow restriction training, Low-intensity training, older adults, Muscle Strength, Cardiovascular safety

    Received: 05 Mar 2025; Accepted: 02 Apr 2025.

    Copyright: © 2025 Ren, Xian, Tan, Sun and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Ming Zhang, Beijing Sport University, Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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