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Effects of blood flow restriction training combined with resistance training on lower-limb strength and sport-specific performance in athletes: a systematic review and meta-analysis.

Qingyu Xu·Yancong Wang·Dan Ma
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Abstract

BACKGROUND: In contemporary sports science, athletes and coaches continuously explore strategies to reduce training load and injury risk while increasing muscular strength and sport-specific performance. This meta-analysis evaluated the effects of blood flow restriction training (BFRT) combined with resistance training (RT) on lower-limb muscle strength and sport-specific performance in athletes. METHODS: Relevant randomized controlled trials (RCTs) were systematically searched across major databases (e.g. PubMed, Web of Science, Cochrane, CNKI, Wanfang Data, and Embase) from inception until November 2024. Two independent reviewers carefully assessed the studies. Data analysis was carried out using RevMan 5.4 software, which included heterogeneity testing, meta-analysis, subgroup analysis, and assessment of publication bias. RESULTS: Ten RCTs (181 athletes; 91 in the BFRT and RT group, 90 in the control group) were included. Outcomes determined BFRT combined with RT yielded notable enhancements in lower-limb muscle strength (SMD = 1.09, 95% CI [0.52, 1.66], p&#x2009;<&#x2009;0.05) and muscle hypertrophy (MD = 1.09, 95% CI [0.10, 2.09], p&#x2009;<&#x2009;0.05) compared to control training. However, no significant improvement in sport-specific performance was found (SMD = 0.11, 95% CI [-0.18, 0.40], p&#x2009;=&#x2009;0.46). Substantial heterogeneity was observed for strength outcomes (I2 = 75%), whereas low heterogeneity was observed for sport-specific performance and hypertrophy outcomes (I2 = 0%). No evidence of significant publication bias was detected. CONCLUSION: BFRT combined with RT appears to provide effective augmentation of lower-limb muscle strength and hypertrophy in athletes compared to RT or conventional training alone. It may be prudent to integrate this approach systematically into training cycles to optimize physiological muscle stimulation and training outcomes, despite not directly improving sport-specific performance.

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HumansResistance TrainingMuscle StrengthLower ExtremityAthletic PerformanceMuscle, SkeletalAthletesBlood Flow Restriction TherapyRandomized Controlled Trials as TopicRegional Blood FlowBlood flow restriction trainingathleteslower limb muscle strengthmeta-analysisresistance trainingJournal ArticleSystematic ReviewMeta-AnalysisResearch Support, Non-U.S. Gov't

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Qingyu Xu, Yancong Wang, Dan Ma. 2026-06-28. Effects of blood flow restriction training combined with resistance training on lower-limb strength and sport-specific performance in athletes: a systematic review and meta-analysis.. https://doi.org/10.1080/07853890.2026.2658885

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