The results of the present systematic review and meta-analysis suggest that blood flow restriction (BFR) is an effective strategy for increasing the effects of low-load (LL) resistance training and walking on muscle mass and strength in older adults. |
In comparison with high-load (HL) resistance training, LL-BFR training produces comparable changes in muscle mass but lower increases in muscular strength. |
The addition of BFR to LL resistance training or walking is an effective exercise alternative for older populations, for whom a traditional HL training might be contraindicated due to comorbidities or high mechanical stress to bones and joints. |
1 Introduction
2 Methods
2.1 Search Strategy
2.2 Inclusion and Exclusion Criteria
2.3 Data Extraction and Assessment of Reviewer Agreement
Study | Subjects | Protocol | N | Exercise mode | Duration/frequency | Strength measurement | Percentage increase | Conclusion |
---|---|---|---|---|---|---|---|---|
Cook et al. [81] | Older adults (≥ 65 y) | LL-BFR (30–50% 1RM) HL (70% 1RM) | 12 12 | Leg curl Leg extension Leg press | 12 wk; 2 days/wk | Isometric leg extension Dynamic leg curl Dynamic leg extension Dynamic leg press | LL-BFR: 10–26% HL: 18–56% | No significant between-group differences except for dynamic leg extension (greater in HL) |
Karabulut et al. [4] | Older men (50–64 y) | LL-BFR (20% 1RM) HL (80% 1RM) | 13 13 | Leg press Leg extension | 6 wk; 3 days/wk | Dynamic leg press Dynamic leg extension | LL-BFR: 19% HL: 20–31% | No significant between-group differences except for dynamic leg extension (greater in HL) |
Libardi et al. [82] | Older adults (> 60 y) | LL-BFR (20–30% 1RM) HL (70-80% 1RM) | 10 8 | Leg press | 12 wk; 2 days/wk | Dynamic leg press | LL-BFR: 35% HL: 38% | No significant between-group differences |
Patterson and Ferguson [83] | Older adults (62–73 y) | LL-BFR (25% 1RM) LL (25% 1RM) | 10 10 | Plantar-flexion | 4 wk; 3 days/wk | Isokinetic plantar flexion 0.52; 1.05; 2.09 rad/s Isometric plantar flexion Dynamic plantar flexion | LL-BFR: 11–20% LL: 0–4% | Greater strength improvements for LL-BFR except for isokinetic torque at 1.05 rad/s and 2.09 rad/s |
Shimizu et al. [84] | Older adults (> 65 y) | LL-BFR (20% 1RM) LL (20% 1RM) | 20 20 | Leg extension Leg press Rowing Chest press | 4 wk; 3 days/wk | Dynamic leg extension Dynamic leg press Dynamic rowing Dynamic chest press | LL-BFR: 6–19% LL: − 2 to 7% | No significant between-group differences |
Thiebaud et al. [85] | Older women (61 ± 5 y) | LL-BFR (10–30% 1RM) HL (70–90% 1RM) | 6 8 | Seated chest press Seated row Seated shoulder press | 8 wk; 3 days/wk | Dynamic chest press Dynamic row Dynamic shoulder press | LL-BFR: 4–10% HL: 5–18% | No significant between-group differences |
Vechin et al. [86] | Older adults (59–71 y) | LL-BFR (20–30% 1RM) HL (70–80% 1RM) | 8 8 | Leg press | 12 wk; 2 days/wk | Dynamic leg press | LL-BFR: 17% HL: 54% | HL tends to result in greater strength increases |
Yasuda et al. [33] | Older women (61–86 y) | LL-BFR (35–45% 1RM) HL (70–90% 1RM) | 10 10 | Squats Knee extension | 12 wk; 2 days/wk | Isometric knee extension Isometric knee flexion Dynamic leg press Dynamic knee extension | LL-BFR: 7–17% HL: 4–18% | Significant increase in LL-BFR group, no significant increase in HL group |
Study | Subjects | Protocol | N | Exercise mode | Duration/frequency | Muscle mass assessment | Percentage increase | Conclusion |
---|---|---|---|---|---|---|---|---|
Cook et al. [81] | Older adults (≥ 65 y) | LL-BFR (30–50% 1RM) HL (70% 1RM) | 12 12 | Leg curl Leg extension Leg press | 12 wk; 2 days/wk | MRI | LL-BFR: 7% HL: 6% | No significant between-group differences |
Libardi et al. [82] | Older adults (> 60 y) | LL-BFR (20–30% 1RM) HL (70–80% 1RM) | 10 8 | Leg press | 12 wk; 2 days/wk | MRI | LL-BFR: 8% HL: 7% | No significant between-group differences |
Thiebaud et al. [85] | Older women (61 ± 5 y) | LL-BFR (10–30% 1RM) HL (70–90% 1RM) | 6 8 | Seated chest press Seated row Seated shoulder press | 8 wk; 3 days/wk | Ultrasound Biceps brachii Triceps brachii Deltoid Pectoralis major DEXA Arm bone-free LBM | LL-BFR: 3–17% HL: − 5 to 7% | No significant between-group differences |
Vechin et al. [86] | Older adults (59–71 y) | LL-BFR (20–30% 1RM) HL (70–80% 1RM) | 8 8 | Leg press | 12 wk; 2 days/wk | MRI | LL-BFR: 6% HL: 7% | Similar increases in both groups |
Yasuda et al. [33] | Older women (61–86 y) | LL-BFR (35–45% 1RM) HL (70–90% 1RM) | 10 10 | Squats Knee extension | 12 wk; 2 days/wk | MRI Quadriceps Adductors Gluteus maximus Hamstring | LL-BFR: 7%a HL: 2%a | No significant between-group differences except for quadriceps CSA (greater in LL-BFR) |
Study | Subjects | Protocol | N | Exercise mode | Duration/frequency | Strength measurement | Percentage increase | Conclusion |
---|---|---|---|---|---|---|---|---|
Clarkson et al. [66] | Older adults (60–80 y) | BFR walking (4 km/h) CON walking (4 km/h) | 10 9 | Walking | 6 wk; 4 days/wk | 30-sec sit-to-stand test | BFR: 28% CON: 8% | Significantly greater strength increases for BFR |
Ozaki et al. [87] | Older adults (57–76 y) | BFR walking (45% HRR) CON walking (45% HRR) | 13 10 | Treadmill walking (20 min) | 10 wk; 4 days/wk | Isokinetic knee extension Isokinetic knee flexion | BFR: 9–15% CON: 0–3% | Significantly greater strength increases for BFR except for knee extension |
Ozaki et al. [67] | Older women (57–73 y) | BFR walking (45% HRR) CON walking (45% HRR) | 10 8 | Treadmill walking (20 min) | 10 wk; 4 days/wk | Isometric knee extension Isokinetic knee extension 30°/s; 180°/s Isokinetic knee flexion 30°/s; 180°/s | BFR: 3–22% CON: − 4 to 2% | Significantly greater strength increases for BFR except for isometric knee extension |
Study | Subjects | Protocol | N | Exercise mode | Duration/frequency | Muscle mass assessment | Percentage increase | Conclusion |
---|---|---|---|---|---|---|---|---|
Ozaki et al. [87] | Older adults (57–76 y) | BFR walking (45% HRR) CON walking (45% HRR) | 13 10 | Treadmill walking (20 min) | 10 wk, 4 days/wk | MRI | BFR: 3% CON: 0% | Significant greater muscle mass increases for BFR |
Ozaki et al. [67] | Older women (57–73 y) | BFR walking (45% HRR) CON walking (45% HRR) | 10 8 | Treadmill walking (20 min) | 10 wk, 4 days/wk | MRI Mid-thigh (CSA) Mid-quadriceps (CSA) Thigh (volume) Quadriceps (volume) | BFR: 3–4% CON: − 2 to 0% | Significant greater muscle mass increases for BFR |