Effects of blood flow restriction combined with high-load training on muscle strength and sports performance in athletes: a systematic review and meta-analysis.

Speed improvements were observed only with absolute pressure (SMD = 1.38, p = 0.003), and endurance improvements approached significance under absolute pressure (SMD = 1.29, p = 0.06), with no significant effect under individualized pressure conditions.

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Short-term interventions (≤6 weeks, SMD = 0.80) had significantly greater effect sizes compared to long-term interventions (>6 weeks, SMD = 0.50), and higher training frequency (≥3 sessions/week, SMD = 0.92) was superior to lower frequency (<3 sessions/week, SMD = 0.33), with subgroup heterogeneity approaching significance (I 2 = 72%, p = 0.06).

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Exclusion of other studies led to effect size fluctuations between 0.694 and 0.990, all maintaining a positive trend.

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A marginal positive trend was observed for low-frequency training (<3 sessions/week) (β = 0.573, 95% CI: −0.19–1.33), but this did not reach statistical significance.

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However, both independently assessed lean mass indicators showed a trend toward improvement in the HL-BFRT group.

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