Can lower limb ischemic preconditioning improve aerobic capacity in healthy adults? A systematic review and meta-analysis

This systematic review and meta-analysis aimed to examine the effects of lower limb ischemic preconditioning (IPC/LL) on aerobic capacity in healthy adults. The search was conducted in five electronic databases. Two authors independently reviewed the search results, extracted the data, and assessed the risk of bias and certainty of evidence. Meta-analyses and subgroup analyses were performed to determine the overall effect size and the impact of potential moderators. Twenty publications consisting of 297 participants were included. The overall analysis showed that time to exhaustion was significantly improved after IPC/LL intervention compared with the control (Hedges' g = 0.40, 95% CI (0.16, 0.64), p < 0.01). In subgroup analysis, time to exhaustion was significantly improved only in single-pass intervention conditions, in untrained participants, and assessed by cycling exercise tests (p < 0.05). However, no significant effect was observed on time trial performance (Hedges' g = -0.08, 95% CI (-0.33, 0.16), p = 0.50), peak oxygen uptake (Hedges' g = 0.02, 95% CI (-0.17, 0.21), p = 0.85), and blood lactate (Hedges' g = 0.09, 95% CI (-0.06, 0.23), p = 0.26) in healthy adults after IPC/LL intervention. This systematic review and meta-analysis provides moderate evidence that IPC/LL does not improve the aerobic capacity of healthy adults but contributes to an enhancement in time to exhaustion during aerobic exercise.