Effects of Low Load Blood Flow Restriction Training on Post-Surgical Musculoskeletal Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: Low-Load Blood Flow Restriction Training (LLBFRT) is an emerging approach in order to increase muscle endurance and muscle volume, as well as decrease pain in the early rehabilitation phase. The purpose of this review was to analyze the published literature on the effects of this intervention on musculoskeletal postsurgical rehabilitation. Methods: Six electronic databases (Cochrane Library, PubMed, SPORTDiscus, SCOPUS, CINAHL, and Web of Science) were searched from 2004 to 2024. Articles including adults who underwent any type of musculoskeletal surgery were screened. The Risk of Bias and Quality of Evidence were assessed using the Cochrane Risk-of-Bias Tool (RoB 2) and GRADE-CERQual scale. A meta-analysis was performed on the identified studies using RevMan version 5.4. The analysis model was synthesized as a random effects model, and the standard mean difference (SMD) was used as the effect measure. Results: Thirteen articles fulfilled the selection criteria and were included in this review. Muscle strength, muscle volume, and perceived pain had positive results in almost all studies; however, the meta-analysis reported a lack of overall effect in favor of LLLBFRT vs. control interventions in both lower and upper limb evaluations. Conclusions: Although some studies indicate positive effects of LLBFRT on strength, muscle size, and pain perception in operated lower and upper limbs, these results must be interpreted carefully since the overall effects are unclear. Nonetheless, the selected studies did not report discomfort claims; therefore, the LLBFRT could be a safe recovery strategy to use when rehabilitation programs need to gain variety.