Sports Medicine

, Volume 45, Issue 3, pp 313–325 | Cite as

Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development

  • Brendan R. ScottEmail author
  • Jeremy P. Loenneke
  • Katie M. Slattery
  • Ben J. Dascombe
Review Article


A growing body of evidence supports the use of moderate blood flow restriction (BFR) combined with low-load resistance exercise to enhance hypertrophic and strength responses in skeletal muscle. Research also suggests that BFR during low-workload aerobic exercise can result in small but significant morphological and strength gains, and BFR alone may attenuate atrophy during periods of unloading. While BFR appears to be beneficial for both clinical and athletic cohorts, there is currently no common consensus amongst scientists and practitioners regarding the best practice for implementing BFR methods. If BFR is not employed appropriately, there is a risk of injury to the participant. It is also important to understand how variations in the cuff application can affect the physiological responses and subsequent adaptation to BFR training. The optimal way to manipulate acute exercise variables, such as exercise type, load, volume, inter-set rest periods and training frequency, must also be considered prior to designing a BFR training programme. The purpose of this review is to provide an evidence-based approach to implementing BFR exercise. These guidelines could be useful for practitioners using BFR training in either clinical or athletic settings, or for researchers in the design of future studies investigating BFR exercise.


Resistance Training Resistance Exercise Blood Flow Restriction Muscular Adaptation Arterial Occlusion Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This review was not funded by any outside organization. There are no conflicts of interest.


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Brendan R. Scott
    • 1
    Email author
  • Jeremy P. Loenneke
    • 2
  • Katie M. Slattery
    • 1
    • 3
  • Ben J. Dascombe
    • 1
  1. 1.Applied Sports Science and Exercise Testing Laboratory, Faculty of Science and Information TechnologyUniversity of NewcastleOurimbahAustralia
  2. 2.Kevser Ermin Applied Physiology Laboratory, Department of Health, Exercise Science, and Recreation ManagementUniversity of MississippiMississippiUSA
  3. 3.New South Wales Institute of SportSydney Olympic ParkUSA

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