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Review
. 2025 Jun 12;14(12):4185.
doi: 10.3390/jcm14124185.

Exploring Blood Flow Restriction Exercise Protocols for Elderly Populations: A Scoping Review of Cuff Pressure, Frequency, and Duration for Muscle Strength, Hypertrophy, and Functional Abilities Outcomes

Mohamed Abdelaziz Emam  1   2 , Ahmed Elsayed  3 , Tibor Hortobágyi  4   5   6 , Wafaa Mahmoud Amin  7   8 , Shazia Malik  7 , Olfat Ibrahim Ali  9
Affiliations
Review

Exploring Blood Flow Restriction Exercise Protocols for Elderly Populations: A Scoping Review of Cuff Pressure, Frequency, and Duration for Muscle Strength, Hypertrophy, and Functional Abilities Outcomes

Mohamed Abdelaziz Emam et al. J Clin Med. .

Abstract

Background/Objectives: As aging leads to a decline in muscle mass, strength, and functional capacity, identifying effective, low-risk interventions for older adults is essential. Blood flow restriction training (BFRT) has gained recognition as a potential substitute for traditional high-load resistance training, offering comparable benefits with reduced mechanical stress. This scoping review explores current BFRT protocols-specifically cuff pressure, training frequency, and duration-and their impact on muscular strength, hypertrophy, and functional capabilities among healthy elderly individuals. Methods: Following PRISMA-ScR and Arksey and O'Malley's framework, six databases were searched (2010-2024), yielding 13 eligible studies. Data were charted for BFRT parameters, training regimens, and outcomes related to strength, muscle size, and functionality. Risk of bias was assessed using Cochrane guidelines. Results: Low-load BFRT (20-40% 1RM), applied 2-4 times weekly for 6-12 weeks, significantly improved muscle strength, hypertrophy (e.g., quadriceps CSA), and functional performance (e.g., TUG, 6MWT). Cuff pressures ranged from 50 to 80% arterial occlusion pressure (AOP) for the lower limbs and 30-50% above systolic pressure for the upper limbs. Wider cuffs enhanced safety and comfort. BFRT demonstrated comparable or superior outcomes to conventional training in most studies, with minimal adverse effects reported. Conclusions: The existing evidence suggests that BFRT may be a promising intervention for improving muscle health and functionality in older adults; however, future research should focus on standardizing protocols, long-term outcomes, and tailored guidelines to optimize safety and efficacy.

Keywords: blood flow restriction training; exercise prescription; functional capacity; hypertrophy; muscle strength; older adults; scoping review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram for new systematic reviews using PRISMA 2020, which included database searches.
Figure 2
Figure 2
Risk of bias summary for included studies [9,19,20,21,22,23,24,25,26,27,28,29,30].
See this image and copyright information in PMC

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