What are the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in patients with rheumatoid arthritis (RA) and osteoarthritis (OA)?
Blood Flow Restriction Cuffs, a systematic review and meta-analysis (PLoS One 2021, PMID 34758045) — no significant differences were found between LIRTBFR, moderate-intensity resistance training (MIRT), and high-intensity resistance training (HIRT) for muscle strength (quadriceps strength: SMD = -0.01, P = 0.96) and functionality (walking patterns: SMD = -0.04, P = 0.82). The abstract for Blood Flow Restriction Cuffs states no limitations.
Source: PLoS One 2021, PMID 34758045 ↗ · Research map · How Magellan grades evidence · evidence confidence: high
PLoS One · 2021 · PMID 34758045 · DOI 10.1371/journal.pone.0259574
Low-intensity resistance training with blood flow restriction can improve muscle strength, mass, and function in arthritis patients, similar to higher intensity training, and better than low-intensity training alone.
The question
What are the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in patients with rheumatoid arthritis (RA) and osteoarthritis (OA)?
What they tested
Low-intensity resistance training combined with blood flow restriction (LIRTBFR) may be a new training strategy for RA and OA patients who may have intolerance to moderate or high-intensity resistance training.
How they did it
A systematic review and meta-analysis of randomized clinical trials (RCTs) published in English between 1957 and 2021 was conducted using MEDLINE (PubMed), Embase, and Cochrane Library. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and risk of bias was assessed using RoB2.0. Mean difference (MD) or standardized mean difference (SMD) and 95% confidence intervals (CI) were pooled using a random-effects model.
What they found
Five RCTs were included. No significant differences were found between LIRTBFR, moderate-intensity resistance training (MIRT), and high-intensity resistance training (HIRT) for muscle strength (quadriceps strength: SMD = -0.01, P = 0.96) and functionality (walking patterns: SMD = -0.04, P = 0.82). Muscle mass gain after LIRTBFR was similar to HIRT. LIRTBFR showed a higher effect on muscle strength (knee extension test) compared to low-intensity resistance training without blood flow restriction (LIRT).
| Muscle Strength (Quadriceps) | -0.01 | |
|---|---|---|
| Functionality (Walking) | -0.04 |
Standardized Mean Difference (SMD) for LIRTBFR compared to MIRT/HIRT on muscle strength and functionality. Values close to zero indicate no significant difference.
What it means
LIRTBFR appears to be a promising strategy for improving muscle strength, muscle mass, and functionality in a sample predominantly composed of women with RA and OA.
Limitations
The abstract does not explicitly state limitations of the meta-analysis, but the small number of included RCTs (five) could be considered an implicit limitation.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Title | Resistance training with blood flow restriction on muscle strength and hypertrophy in arthritis: a meta-analysis |
|---|---|
| Journal | PLoS One |
| Year | 2021 |
| PMID | 34758045 ↗ |
| DOI | 10.1371/journal.pone.0259574 ↗ |
| Topic | Muscle, strength & physical function |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Blood Flow Restriction Cuffs
Meta-analyses of randomized trials show that low-load resistance training with blood flow restriction increases muscle strength and size more than the same light loads without occlusion, and produces muscle hypertrophy comparable to heavy-load training, although heavy loads still tend to yield somewhat greater gains…
Blood flow restriction (BFR) training pairs low-load exercise (typically 20-40% of one-repetition…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Molecules & mechanisms in this paper
Each of these is named in the paper’s own words above. Open the monograph for the full mechanism and its other citations.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What are the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in patients with rheumatoid arthritis (RA) and osteoarthritis (OA)? [Plain-English summary of PLoS One 2021, PMID 34758045, DOI 10.1371/journal.pone.0259574]. Magellan Longevity. https://magellanlongevity.com/study/d34758045.html@misc{magellan_d34758045,
title = {What are the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in patients with rheumatoid arthritis (RA) and osteoarthritis (OA)?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/d34758045.html}},
note = {Plain-English summary of PubMed PMID 34758045; DOI 10.1371/journal.pone.0259574; PLoS One 2021. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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