Hypertrophic effects of low-load blood flow restriction training with different repetition schemes: A systematic review and meta-analysis

Abstract This systematic review and meta-analysis analyzed the effect of low-load resistance training (LL-RT) with blood flow restriction (BFR) versus high-load resistance training (HL-RT) on muscle hypertrophy focusing on the repetition scheme adopted. Four databases were searched to identify randomized controlled trials that compared the effect of LL-RT with BFR versus HL-RT on muscle hypertrophy. Standardized mean differences (SMD) were pooled in a random effects meta-analysis. The overall analysis did not demonstrate significant differences between conditions (SMD = 0.0364; p = 0.196). A similar result was observed when we separately analyzed studies that used sets to momentary muscle failure (SMD = 0.034; p = 0.522), sets of 15 repetitions (SMD = -0.019; p = 747) and a fixed repetition scheme composed of 75 repetitions (SMD = 0.088; p = 0.177). Subgroup analysis on body region indicates no difference in lower limb exercise between HL-RT and LL-RT with BFR (SMD = 0.00065; p = 0.978) while upper limb exercise favors HL-RT (SMD = 0.2313; p = 0.005). In conclusion, LL-RT with BFR elicits muscle hypertrophy similar to HL-RT regardless of the employed repetition scheme, although there appears to be a small beneficial effect in favor of HL-RT in upper limb exercise.