Can blood flow restriction induce cross-education of muscle strength and volume? A systematic review and meta-analysis

Abstract

Objective: This research systematically assesses the effects of low-load blood flow restriction on the cross-education of muscle strength and volume, providing evidence-based guidance for clinicians and rehabilitation therapists. Method: The literature search utilized databases such as PubMed, Web of Science, and Embase. Quality assessment employed the Cochrane Collaboration’s RCT bias evaluation tool. Data synthesis, forest plot creation, and publication bias assessment were performed with Reman 5.4 software. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), 202440038. Result: Six meta-analyses, encompassing 259 undergraduate students, were performed. Results indicated a markedly enhanced cross-education effect in muscle strength induction via blood flow restriction, surpassing that of traditional unilateral training and control groups. Nonetheless, the cross-education impact on muscle volume induction showed no notable variance among the groups. Conclusion: Blood flow restriction has been shown to effectively induce cross-education in muscle strength. Nevertheless, additional research is required to determine its impact on muscle volume cross-education. Reduced exercise intensity with blood flow restriction may augment neural activation, implying possible advantages in rehabilitative training for individuals with neurological conditions-meriting additional investigation.