Hemodynamic analysis of blood flow restriction training: a systematic review

Abstract Blood Flow Restriction Training (BFRT) is a low-load training technique that involves applying pressure to partially restrict arterial blood flow while occluding venous return. Despite its growing popularity, there is still no consensus on how combining BFRT with resistance or aerobic training influences hemodynamic responses, or on the safest and most effective methods for implementing it. This review aims to systematically identify the effects of BFRT on hemodynamic parameters. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. The Chinese literature search was performed in the China National Knowledge Infrastructure (CNKI) database. English literature search was conducted in the Web of Science, PubMed, and Google Scholar databases. The studies included human subjects, the outcome indicators included hemodynamic evaluation indicators, and only randomized controlled trials and randomized crossover trials were considered. Non-Chinese or English literature, duplicate studies, and those with missing data were excluded. The adapted STROBE checklist was used to assess the risk of bias, 44 articles were included in this review. Results indicated that BFRT has increased heart rate and blood lactate levels, while its effect on blood oxygen saturation varies. Additionally, BFRT significantly enhances cardiac output but may either have no significant effect or cause a decrease in stroke volume. Furthermore, BFRT improves pulse wave velocity from the femur to the posterior tibia, suggesting a positive influence on cardiovascular function. BFRT induces changes in arterial structure and function, with these indicators interacting to produce both positive and negative effects on cardiovascular health. The primary mechanisms by which BFRT influences hemodynamics include the activation of the sympathetic and vagus nerves, as well as the regulation of chemical mediators in body fluids that modulate cardiovascular function. Convenient, economical, non-invasive, and easily measurable hemodynamic indicators are expected to become an efficient tool for evaluating the effects of exercise training. Further research is needed to establish the optimal compression thresholds and durations for different populations and exercise types, as well as to assess the long-term impact of BFRT on hemodynamic parameters.