Effects of low-load blood flow restriction training in healthy adult tendons: A systematic review and meta-analysis

Abstract

Objective To systematically review the effects of low-load blood flow restriction training (LL-BFR) on healthy adult tendons. Design A systematic review with meta-analysis. Literature search Six electronic databases were searched by two researchers. Study selection criteria Clinical trials comparing the effects of LL-BFR to high-load resistance training (HL-RT) or low-load resistance training (LL-RT) in healthy adult tendons. Data synthesis Two reviewers selected the eligible clinical trials, and one reviewer exported the data. Two reviewers evaluated the study quality and risk of bias using the PEDro scale and the ROB2 scale. We performed meta-analysis where appropriate using a random-effects model. We rated the quality of evidence using GRADE. Results Six studies were eligible. We analyzed tendon cross-sectional area (CSA) and tendon stiffness as the outcomes. Across all comparisons, there was low-to moderate-quality evidence of a difference between LL-BFR and LL-RT immediately after exercise. There was high-quality evidence of no difference between LL-BFR and HL-RT in the long term. Conclusion The effects of LL-BFR on the tendons depends on the time and dose of the intervention. LL-BFR could be useful to increase the CSA of the tendons in a similar or superior way to HL-RT after 8 weeks of intervention.