Effect of blood flow restricted walking on cardiovascular fitness, muscular development, and functional performance in adults: A systematic review with meta-analysis.
Michael Beere, James R Mckee, Isaac Selva Raj et al.
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In 30 seconds
This systematic review and meta-analysis assessed blood flow restriction (BFR) walking versus walking without BFR in adults. It included 12 randomised controlled trials meeting minimum intervention and measurement criteria. BFR walking was associated with improvements across cardiovascular fitness, lower-limb strength, muscle hypertrophy and functional performance; the largest reported effect was for functional performance (g = 0.57, CI95%: 0.21 to 0.92). The authors report these adaptations occurred without additional workload, while noting that evidence is insufficient to establish specific BFR-walking prescription guidelines.
Key findings
- Compared with non-BFR walking, BFR walking improved cardiovascular fitness (g = 0.31, CI95%: 0.05 to 0.59).
- Lower-limb strength improved with BFR walking (g = 0.32, CI95%: 0.06 to 0.57), as did hypertrophy (g = 0.26, CI95%: 0.01 to 0.51).
- Functional performance showed the largest reported effect (g = 0.57, CI95%: 0.21 to 0.92).
- Exercise intensity and volume did not seem to significantly affect adaptations, according to the review.
Why it matters
BFR walking may offer a way to obtain fitness, strength and functional gains without increasing walking workload. This could be relevant where higher exercise loads are difficult to tolerate, including older or clinical populations. However, the review reports low to very low study quality and high risk of bias, so the estimated benefits should be interpreted cautiously.
What to keep in mind
The included studies were judged to have low to very low quality and high risk of bias, reducing confidence in the findings. The review also notes that more evidence is needed to establish specific prescription guidelines.