Blood flow restriction training in musculoskeletal rehabilitation: a comprehensive scoping review of randomised controlled trials.
5 affiliations
- 1Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Türkiye. [email protected].
- 2Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Niğde Ömer Halisdemir University, Niğde, Türkiye. [email protected].
- 3Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Haliç University, Istanbul, Türkiye.
- 4Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Türkiye.
- 5Department of Physiotherapy and Rehabilitation, Doctoral Student, Marmara University, Institute of Health Sciences, Istanbul, Türkiye.
Abstract
Context
Blood Flow Restriction Training (BFRT) is increasingly used in musculoskeletal rehabilitation because low-load exercise with blood flow restriction can elicit strength and hypertrophy adaptations and may be suitable for individuals who cannot tolerate high-load training. There is also growing interest in its potential effects on pain, function, and quality of life across rehabilitation outcomes.Aim
This scoping review aimed to map and synthesise evidence from randomised controlled trials on BFRT in musculoskeletal rehabilitation and to classify reported outcomes according to International Classification of Functioning, Disability and Health (ICF) domains from a physiotherapy and rehabilitation perspective.Method
This scoping review searched the literature between November 2024 and January 2025 via Marmara University Library VETIS remote access using PubMed, OVID, Web of Science, and Scopus. The following search strategy was applied: [("Blood Flow Restriction" OR "Occlusion Training") AND ("Rehabilitation" OR "Physiotherapy" OR "Physical Therapy")];. The review was not registered in PROSPERO due to the scoping review design. Eligible studies were English-language, peer-reviewed randomised controlled trials published within the last 10 years. Non-randomised designs and acute-only studies were excluded. Screening was performed independently by four reviewers, with disagreements resolved by a fifth reviewer. Outcomes were synthesised under International Classification of Functioning, Disability and Health domains, and methodological quality was assessed using the PEDro scale.Conclusion
The search yielded 868 records, and 21 randomised controlled trials were included after duplicate removal and screening. Interventions and protocols varied substantially across studies in terms of cuff parameters, training duration, and frequency. The 21 analyzed moderate to high quality RCTs demonstrated that low load BFRT (20 to 35% 1RM, 60 to 80% occlusion, 4 to 12 weeks) yielded significant improvements in body functions across 11 different musculoskeletal conditions, which positively translated into activity capacity. Evidence concerning the participation domain was limited to only 7 of the 21 studies and is currently restricted to changes in quality of life. Return to work was not measured in any included study, and return to sport was not assessed using metrics based on clearance. Mapping based on the ICF indicates that while BFRT effects are strongly evidenced at the body functions and structures and activity levels, evidence at the participation level remains insufficient, identifying return to work and return to sport outcomes based on clearance as priority knowledge gaps for future trials.
Related
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BibTeX
@article{atmaca2026blood,
title = {{Blood flow restriction training in musculoskeletal rehabilitation: a comprehensive scoping review of randomised controlled trials.}},
author = {Sema Nur Atmaca and Betül Beyza Çolak and Ece Zeynep Saatçı and Nasim Ejraei and Aysel Yıldız Özer},
journal = {BMC sports science, medicine \& rehabilitation},
year = {2026},
month = aug,
doi = {10.1186/s13102-026-01941-0},
url = {https://europepmc.org/article/MED/42972440},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Blood flow restriction training in musculoskeletal rehabilitation: a comprehensive scoping review of randomised controlled trials.
AU - Sema Nur Atmaca
AU - Betül Beyza Çolak
AU - Ece Zeynep Saatçı
AU - Nasim Ejraei
AU - Aysel Yıldız Özer
PY - 2026
DA - 2026/08/05
JO - BMC sports science, medicine & rehabilitation
DO - 10.1186/s13102-026-01941-0
UR - https://europepmc.org/article/MED/42972440
AB - Context Blood Flow Restriction Training (BFRT) is increasingly used in musculoskeletal rehabilitation because low-load exercise with blood flow restriction can elicit strength and hypertrophy adaptations and may be suitable for individuals who cannot tolerate high-load training. There is also growing interest in its potential effects on pain, function, and quality of life across rehabilitation outcomes.Aim This scoping review aimed to map and synthesise evidence from randomised controlled trials on BFRT in musculoskeletal rehabilitation and to classify reported outcomes according to International Classification of Functioning, Disability and Health (ICF) domains from a physiotherapy and rehabilitation perspective.Method This scoping review searched the literature between November 2024 and January 2025 via Marmara University Library VETIS remote access using PubMed, OVID, Web of Science, and Scopus. The following search strategy was applied: [("Blood Flow Restriction" OR "Occlusion Training") AND ("Rehabilitation" OR "Physiotherapy" OR "Physical Therapy")];. The review was not registered in PROSPERO due to the scoping review design. Eligible studies were English-language, peer-reviewed randomised controlled trials published within the last 10 years. Non-randomised designs and acute-only studies were excluded. Screening was performed independently by four reviewers, with disagreements resolved by a fifth reviewer. Outcomes were synthesised under International Classification of Functioning, Disability and Health domains, and methodological quality was assessed using the PEDro scale.Conclusion The search yielded 868 records, and 21 randomised controlled trials were included after duplicate removal and screening. Interventions and protocols varied substantially across studies in terms of cuff parameters, training duration, and frequency. The 21 analyzed moderate to high quality RCTs demonstrated that low load BFRT (20 to 35% 1RM, 60 to 80% occlusion, 4 to 12 weeks) yielded significant improvements in body functions across 11 different musculoskeletal conditions, which positively translated into activity capacity. Evidence concerning the participation domain was limited to only 7 of the 21 studies and is currently restricted to changes in quality of life. Return to work was not measured in any included study, and return to sport was not assessed using metrics based on clearance. Mapping based on the ICF indicates that while BFRT effects are strongly evidenced at the body functions and structures and activity levels, evidence at the participation level remains insufficient, identifying return to work and return to sport outcomes based on clearance as priority knowledge gaps for future trials.
SN - 2052-1847
ER -