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Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development

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Abstract

A growing body of evidence supports the use of moderate blood flow restriction (BFR) combined with low-load resistance exercise to enhance hypertrophic and strength responses in skeletal muscle. Research also suggests that BFR during low-workload aerobic exercise can result in small but significant morphological and strength gains, and BFR alone may attenuate atrophy during periods of unloading. While BFR appears to be beneficial for both clinical and athletic cohorts, there is currently no common consensus amongst scientists and practitioners regarding the best practice for implementing BFR methods. If BFR is not employed appropriately, there is a risk of injury to the participant. It is also important to understand how variations in the cuff application can affect the physiological responses and subsequent adaptation to BFR training. The optimal way to manipulate acute exercise variables, such as exercise type, load, volume, inter-set rest periods and training frequency, must also be considered prior to designing a BFR training programme. The purpose of this review is to provide an evidence-based approach to implementing BFR exercise. These guidelines could be useful for practitioners using BFR training in either clinical or athletic settings, or for researchers in the design of future studies investigating BFR exercise.

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Acknowledgments

This review was not funded by any outside organization. There are no conflicts of interest.

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Authors and Affiliations

  1. Applied Sports Science and Exercise Testing Laboratory, Faculty of Science and Information Technology, University of Newcastle, PO Box 127, Ourimbah, NSW, 2258, Australia

    Brendan R. Scott, Katie M. Slattery & Ben J. Dascombe

  2. Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Mississippi, MS, USA

    Jeremy P. Loenneke

  3. New South Wales Institute of Sport, Sydney Olympic Park, NSW, USA

    Katie M. Slattery

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  1. Brendan R. Scott
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Correspondence to Brendan R. Scott.

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Scott, B.R., Loenneke, J.P., Slattery, K.M. et al. Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development. Sports Med 45, 313–325 (2015). https://doi.org/10.1007/s40279-014-0288-1

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