Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (8): 1705-1713.doi: 10.12307/2025.313

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Effects of blood flow restriction training combined with resistance training on muscle indicators in college athletes: a meta-analysis 

Zhang Zixian1, Xu Youliang2, Wu Shaokui2, 3, Wang Xiangying1   

  1. 1School of Physical Education, Shandong Normal University, Jinan 250358, Shandong Province, China; 2School of Physical Education & Health, East China Normal University, Shanghai 200241, China; 3School of Physical Education, Guizhou University, Guiyang 550025, Guizhou Province, China
  • Received:2024-02-18 Accepted:2024-03-30 Online:2025-03-18 Published:2024-07-06
  • Contact: Wu Shaokui, PhD candidate, School of Physical Education & Health, East China Normal University, Shanghai 200241, China; School of Physical Education, Guizhou University, Guiyang 550025, Guizhou Province, China Co-corresponding author: Wang Xiangying, PhD, Professor, Master’s supervisor, School of Physical Education, Shandong Normal University, Jinan 250358, Shandong Province, China
  • About author:Zhang Zixian, Master candidate, School of Physical Education, Shandong Normal University, Jinan 250358, Shandong Province, China
  • Supported by:
    General Project of National Social Science Foundation, No. 20BTY087 (to WXY [Project participant])

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Abstract: OBJECTIVE: This paper collects relevant literature on blood flow restriction training combined with resistance training, and analyzes the different effects of blood flow restriction training combined with resistance training on athletes’ muscle-related indexes and specialized abilities in accordance with the paradigm of systematic evaluation and Meta-analysis, aiming to provide data support for athletes to utilize blood flow restriction training in their training practices.
METHODS: Chinese and foreign databases (CNKI, WanFang, PubMed, Web of Science, SPORTDiscus) were searched to collect randomized controlled trials on the effects of blood flow restriction training combined with resistance training on limb circumference, muscle mass, muscle strength, and specialized ability of college athletes from January 1st, 2000 to October 12th, 2023. At least two researchers evaluated the quality of the included literature using the Cochrane Collaboration risk of bias assessment tools and criteria. Heterogeneity tests, data merging, subgroup analyses, forest plotting, and sensitivity analyses were performed using RevMan 5.4, and funnel plots with publication bias evaluation and sensitivity analyses were performed. The evaluation indexes were limb circumference, muscle thickness, muscle strength and specialized ability, and subgroup analyses were performed for different specialized athletic abilities.
RESULTS: (1) A total of 18 randomized controlled trials with 403 subjects were included, and according to the Cochrane Collaboration’s risk of bias assessment tool, the quality of literature in the included literature was grade A in 16 articles and grade B in 2 articles. (2) Comparing the effects of blood flow restriction training combined with resistance training and resistance training, there was no significant difference between the two groups in terms of limb circumference [standardized mean difference (SMD)=0.03, 95% confidence interval: -0.16-0.21, P=0.78], and a significant difference between the two groups in terms of muscle thickness (SMD=0.14, 95% CI: 0.01-0.27, P=0.03) and muscle strength (SMD=0.37, 95% CI: 0.14-0.60, P=0.001). (3) Subgroup analyses of the indicators of specialized capacity indicated that there was high heterogeneity in the analyzed results of distance metrics (I2=73%) and time metrics (I2=55%), which was analyzed as a possible reason due to the differences in testing methods and assessment of metrics’ significance in the studies; there was no heterogeneity (I2=0%) in the analyzed results of power metrics; blood flow restriction training combined with resistance training had a significant effect on distance metrics 
(P < 0.01). (4) The results of the combined effect showed the effect of blood flow restriction training combined with resistance training vs. resistance training for specialized ability (P=0.41), suggesting that there is no significant effect of different training methods on specialized ability. 
CONCLUSION: Both blood flow restriction training combined with resistance training and resistance training can promote muscle thickness, muscle strength and specialized ability in college athletes. Meanwhile, blood flow restriction training combined with resistance training has a more significant effect on muscle thickness, muscle strength and some specialized abilities compared with resistance training. Therefore, blood flow restriction training can be scientifically and rationally integrated into specialized training, so as to achieve a better training effect by integrating the differentiated physiological stimuli to the muscles. However, due to the small number of included studies and other possible limitations, more high-quality, multi-sport type and sex randomized trials need to be included in the future to confirm this.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: blood flow restriction training, resistance training, college athlete, limb circumference, muscle thickness, muscle strength, specialized ability, meta-analysis

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