Acute and Chronic Effects of Blood Flow Restricted High-Intensity Interval Training: A Systematic Review

Chua, Man Tong; Sim, Alexiaa; Burns, Stephen Francis

doi:10.1186/s40798-022-00506-y

Sports Medicine - Open

Table 4 Chronic performance (aerobic, anaerobic, muscular) effects of BFR + HIIT protocols

From: Acute and Chronic Effects of Blood Flow Restricted High-Intensity Interval Training: A Systematic Review

References	Participant profile	Study design	BFR methodology			Exercise intervention		Performance outcomes	p-value
References	Participant profile	Study design	Site of BFR	Cuff pressure	Application procedure	Number of sessions	Exercise protocol	Performance outcomes	p-value
Keramidas et al. [18]	n = 20 healthy, untrained subjects (6 men, 14 women)	(1) BFR (2) CON	Proximal portion of each thigh	(1) 90 mmHg (2) No BFR	Pneumatic cuffs, inflated during exercise bouts, depressurised during active recovery	18 sessions, 3 sessions per week for 6 weeks	Bouts of 2-min cycling (90% VO ₂ _max OR VO ₂ _maxPRESS), 2-min recovery (50% VO ₂ _max OR VO ₂ _maxPRESS)	Aerobic
								No changes in \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\), HR_max, RPE, RPE (legs), AT in both groups	All p > 0.05
								↑* MAP (CON: 15%; BFR: 25%), VE_max in both groups	Both p < 0.001
								↓* \(\dot{\mathrm{V}}{\mathrm{O}}_{2}\) (from ~ 78% to ~ 72%) during submaximal test in both groups	All p < 0.05
								↑* TTF at 150%MAP in both groups	p < 0.05
Taylor et al. [27]	n = 20 healthy trained male cyclist	(1) BFR (2) CON	Proximal portion of each thigh	(1) ~ 130 mmHg (2) No BFR	Pneumatic cuffs, inflated within 15 s after each sprint, 2-min into rest	8 sessions, 2 sessions per week for 4 weeks	SIT: 30-s maximal effort sprint cycling, with 4.5 min recovery 4, 5, 6, 7 sets	Aerobic
								↑* MPO during training in CON than BFR	p < 0.01
								↑* \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) (4.5%) only in BFR	p = 0.01
								No changes in 15 km TT performance time	p > 0.05
								Anaerobic
								↑* Sprint PPO in both groups (CON: 6.8%; BFR: 6.4%)	p = 0.02
Behringer et al. [32]	n = 25 healthy male sport students	(1) BFR (2) CON	Proximal part of upper thighs	(1) Moderate perceived pressure (7/10) (2) No BFR	p-BFR, wrapped during entirety of exercise duration	12 sessions, 2 sessions a week for 6 weeks	6 sets of 100 m sprints at 60–70% best sprinting time, with 1-min recovery	Anaerobic
Behringer et al. [32]	n = 25 healthy male sport students	(1) BFR (2) CON	Proximal part of upper thighs	(1) Moderate perceived pressure (7/10) (2) No BFR	p-BFR, wrapped during entirety of exercise duration	12 sessions, 2 sessions a week for 6 weeks		↓* Sprint times in BFR (− 0.38 s, 3%) as compared to CON (− 0.16 s, 1.3%)	p < 0.05
								Muscular
								↑* RFD in BFR (6kN/s, 24.9%) more than CON (0.4kN/s, 1.7%)	p = 0.02
								↑* Muscle thickness of rectus femoris in BFR	p = 0.004
Paton et al. [10]	n = 16 healthy, active subjects (10 males, 6 females)	(1) BFR (2) CON	Proximal portion of thighs	(1) Moderate perceived pressure (7/10) (2) No BFR	p-BFR, wrapped during exercise bout, removed between sets	8 sessions, 2 sessions per week for 4 weeks	30-s running at 80% PRV), 30-s rest 2 sets of 5 reps in session 1 to 3 sets of 8 reps in session 8	Aerobic
Paton et al. [10]	n = 16 healthy, active subjects (10 males, 6 females)	(1) BFR (2) CON	Proximal portion of thighs	(1) Moderate perceived pressure (7/10) (2) No BFR	p-BFR, wrapped during exercise bout, removed between sets	8 sessions, 2 sessions per week for 4 weeks		↑ \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) (BFR:6.4% vs CON:4.0%) and TTE (BFR:26% vs CON: 17%) in both groups	All between group p > 0.05
								↑ PRV (BFR:3.6% vs CON:1.4%) incremental run time (BFR:6.1% vs 2.0%) in both groups
								↑ RE (-6.7%) only in BFR
Amani-Shalamzari et al. [15]ª	n = 32 healthy active collegiate females	All BFR (1) IP-CE (2) CPP-IE (3) CPC-IE (4) IP-IE	Proximal portion of thighs	Varies on condition Refer to article for exact BFR protocols	Pneumatic cuffs, inflated during exercise bouts, deflated during recovery	12 sessions, 3 sessions per week for 4 weeks	2-min running with 1-min recovery × 10 sets except for IP-IE group Exercise intensities vary depending on group	Aerobic
								↑*\(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) ( IP-CE: 9.6%; CPP-IE: 11.2%; CPC-IE: 14.8%; IP-IE: 8.4%) and v \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) in all groups	All p < 0.05
								↑*%RE in IP-CE (− 5.6%; CPP-IE: -9.6%; CPC-IE: -17.6%), but not in IP-IE	All p < 0.05
								↑* TTF in all groups	All p < 0.05
								Anaerobic
								↑*PPO (IP-CE: 21.3% CPP-IE: 17.5%; CPC-IE: 28.1%; IP-IE: 13.5%) and MPO in all groups	All p < 0.05
								Muscular ↑* Muscle strength (IP-CE: 18.8%; CPP-IE: 20%; CPC-IE: 31.0%; IP-IE: 20.5%)	All p < 0.05
Amani-Shalamzari et al. [19]	N = 12 male futsal players, > 5 years Iran National league 2^nd Division	(1) BFR (2) CON	Proximal portion of thighs	(1) BFR 110% leg’s SBP. Increased 10% after every 2 sessions (2) No BFR Exact pressure values not specified	Pneumatic cuffs, inflated during exercise, deflated during rest periods	10 sessions across 3 weeks	3-a-side futsal game, 3-min activity, 2-min rest Sessions 1–3: 4 sets Sessions 4–7: 6 sets Sessions 8–9: 8 sets Session 10: 4 sets	Muscular
								↑* Peak torque for knee extension and flexion, more in BFR (30.9% and 23.8%) than in CON (14.9% and 8.1%)	p = 0.01
								↑* iEMG of m.vastus lateralis, m. vastus medialis in both groups	p = 0.01
								↑* iEMG m.rectus femoris more in BFR than CON	p = 0.02
Amani-Shalamzari,et al. [20]								Aerobic
								↑* \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) and v \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) in both groups (BFR:11.1% and 4.2%, CON: 6.8% and 2.2%)	Both p < 0.05
								↑*TTF and RE only in BFR (BFR:10.3% and -22.7% vs CON: 3.9% and − 4.2%)	Both p < 0.05
								Anaerobic
								↑*PPO in both groups (BFR:12.7%, CON: 4.8%)	p < 0.05
								↑*MPO only in BFR group (BFR:12.2% vs CON: 1.7%)	p < 0.05
Christiansen, et al. [13]	n = 10 healthy, recreationally active men	(1) BFR leg (2) CON leg	Proximal portion of each thigh	(1) ~ 180 mmHg (2) No BFR	Pneumatic cuffs, inflated ~ 10-s prior to and deflated after each exercise bout	18 sessions, 3 times a week for 6 weeks	3 × 2-min cycling bouts, with 1-min rest. Total 3 sets, 2-min active recovery between sets 60%, 70%, 80% W_max in each set	Muscular
Christiansen, et al. [13]	n = 10 healthy, recreationally active men	(1) BFR leg (2) CON leg	Proximal portion of each thigh	(1) ~ 180 mmHg (2) No BFR		18 sessions, 3 times a week for 6 weeks		↑*iPPO in knee-extensor performance in BFR (23%) more than CON leg (12%)	p < 0.05
Christiansen, et al. [14]								↑*TTE in BFR (21%) more than CON leg (11%)	p = 0.001
Christiansen et al. [11]								↓*Relative intensity at 90% pre-training iPPO in BFR (18%) more than in CON(9%) leg	p = 0.002
Christiansen et al. [12]								↑*Power output at 25%iPPO in BFR(20%) more than CON(9%) leg	p = 0.017
Mitchell et al. [16]	n = 21 healthy males, competitive cyclists or triathletes	(1) BFR (2) CON	Proximal portion of each thigh	(1) ~ 120 mmHg (2) No BFR	Pneumatic cuffs, inflated within 25-s after each sprint, 2-min into rest	8 sessions, 2 sessions per week for 4 weeks	SIT: 30-s maximal effort sprint cycling, with 4.5 min recovery 4, 5, 6, 7 sets	Aerobic ↑* \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) (5.9%) only in BFR	p = 0.04
Mitchell et al. [16]	n = 21 healthy males, competitive cyclists or triathletes	(1) BFR (2) CON	Proximal portion of each thigh	(1) ~ 120 mmHg (2) No BFR		8 sessions, 2 sessions per week for 4 weeks		↑* Relative MAP (CON:1.5% and BFR: 3.5%), CP (CON:3.6% and BFR: 3.3%)	All p < 0.05
								Anaerobic
								↑*PPO (CON:5.2% and BFR: 7.2%) but no difference between them	Both p < 0.05
Elgammal et al. [17]	n = 24 highly trained university basketball players	(1) BFR (2) CON	Proximal region of thighs	(1) 100 mmHg, increased by 10 mmHg every session till 160 mmHg (2) No BFR	Pneumatic cuffs, inflated right before RS exercise	12 sessions, 3 sessions per week for 4 weeks	RST: 8 × maximal effort 15 m by 15 m sprints, with 20-s rest between reps 3 sets, with 4 min rest between sets	Aerobic ↑* \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) in BFR (20.6%) more than CON (15%)	p = 0.04
								Anaerobic
								No differences in changes in suicide run tests in both groups	p = 0.25
								Muscular
								↑* 1RM Half-squat in BFR (17.8%) more than in CON (11.4%)	p = 0.02
								↑* 1RM Bench press in both groups (BFR: 14.1%, CON: 9.8%)	p < 0.05

↑*—significant increase, ↓*—significant decrease, Δ—changes, 1RM—1 repetition-maximum, AOP—arterial occlusion pressure, BFR—blood flow restriction, CON—control, CP—critical power, CPP-IE—constant partial occlusion pressure, increasing exercise intensity, CPC-IE—constant complete occlusion pressure, increasing exercise intensity, \({\mathrm{HR}}_{\mathrm{max}}\)– maximal heart rate, iEMG—integrated myography, IP-CE—increasing occlusion pressure, constant exercise intensity, IP-IE—increasing occlusion pressure, increasing exercise intensity, MPO—mean power output p-BFR, practical blood flow restriction, PRV—peak running velocity, iPPO—incremental peak power output, PPO—peak power output, RFD—rate of force development, RE—running economy, RPE—rating of perceived exertion, SIT—sprint interval training, TT—time trial, TTE—time to exhaustion, TTF—time to fatigue, \(\dot{\mathrm{V}}\mathrm{CO}_2\)—carbon dioxide output, \(\mathrm{VE}\)—minute ventilation, \({\mathrm{VE}}_{\mathrm{max}}\)– maximal exercise ventilation, \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\)—maximal oxygen uptake, \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\) PRESS—maximal oxygen uptake from graded test with BFR, v \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\)—running velocity at \(\dot{\mathrm{V}}{\mathrm{O}}_{2\mathrm{max}}\),—\({\mathrm{W}}_{\mathrm{max}}\)maximal aerobic power
ª Research only included BFR groups, for exact BFR protocols please refer to the article

Back to article page