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. 2020 Mar;9(2):152-159.
doi: 10.1016/j.jshs.2019.07.001. Epub 2019 Jul 5.

Effects of blood flow restriction without additional exercise on strength reductions and muscular atrophy following immobilization: A systematic review

Mikhail Santos Cerqueira  1 , José Diego Sales Do Nascimento  2 , Daniel Germano Maciel  3 , Jean Artur Mendonça Barboza  3 , Wouber Hérickson De Brito Vieira  3
Affiliations

Effects of blood flow restriction without additional exercise on strength reductions and muscular atrophy following immobilization: A systematic review

Mikhail Santos Cerqueira et al. J Sport Health Sci. 2020 Mar.

Abstract

Purpose: To investigate whether blood flow restriction (BFR) without concomitant exercise mitigated strength reduction and atrophy of thigh muscles in subjects under immobilization for lower limbs.

Methods: The following databases were searched: PubMed, CINAHL, PEDro, Web of Science, Central, and Scopus.

Results: The search identified 3 eligible studies, and the total sample in the identified studies consisted of 38 participants. Isokinetic and isometric torque of the knee flexors and extensors was examined in 2 studies. Cross-sectional area of thigh muscles was evaluated in 1 study, and thigh girth was measured in 2 studies. The BFR protocol was 5 sets of 5 min of occlusion and 3 min of free flow, twice daily for approximately 2 weeks. As a whole, the included studies indicate that BFR without exercise is able to minimize strength reduction and muscular atrophy after immobilization. It is crucial to emphasize, however, that the included studies showed a high risk of bias, especially regarding allocation concealment, blinding of outcome assessment, intention-to-treat analyses, and group similarity at baseline.

Conclusion: Although potentially useful, the high risk of bias presented by original studies limits the indication of BFR without concomitant exercise as an effective countermeasure against strength reduction and atrophy mediated by immobilization.

Keywords: Disuse; Hypoxia; Ischemia; Muscle wasting; Rehabilitation.

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Figures

Image, graphical abstract
Graphical abstract
Fig 1
Fig. 1
Flow diagram of the selection steps of the identified articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. BFR = blood flow restriction.
Fig 2
Fig. 2
Risk of bias summary: review authors' judgments about each risk of bias item for each included study.
Fig 3
Fig. 3
Risk of bias graph: review authors’ judgments about each risk of bias item presented as percentages across all included studies.
See this image and copyright information in PMC

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