---
title: "Resistance training with blood flow restriction on muscle…"
description: "Low-intensity resistance training with blood flow restriction can improve muscle strength, mass, and function in arthritis patients, similar to higher…"
url: "https://magellanlongevity.com/study/d34758045.md"
canonical: "https://magellanlongevity.com/study/d34758045.html"
html: "https://magellanlongevity.com/study/d34758045.html"
type: "study"
study_key: "d34758045"
journal: "PLoS One"
year: 2021
pmid: "34758045"
doi: "10.1371/journal.pone.0259574"
citations: 1
updated: 2026-09-02
author: "Gabriel Radu, DO"
author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765."
publisher: "Magellan Longevity"
content_format: "markdown"
---

# Resistance training with blood flow restriction on muscle strength and hypertrophy in arthritis: a meta-analysis

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## Citation

| Field | Value |
| --- | --- |
| Journal | PLoS One |
| Year | 2021 |
| PMID | [34758045](https://pubmed.ncbi.nlm.nih.gov/34758045/) |
| DOI | [10.1371/journal.pone.0259574](https://doi.org/10.1371/journal.pone.0259574) |
| Study key | d34758045 |

## Takeaway

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)?

## Hypothesis

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.

## Methods

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.

## Results

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).

## Conclusion

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.

## Verbatim from the abstract

> blood flow restriction training is a promising strategy for gains in muscle strength, mass and functionality

## Comparison of LIRTBFR with MIRT/HIRT on Muscle Strength and Functionality

| Measure | Standardized Mean Difference (SMD) |
| --- | --- |
| 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.*

## Where this study is used on Magellan

This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions.

| Compound or device | Evidence grade | Graded pages |
| --- | --- | --- |
| Blood Flow Restriction Cuffs | Moderate evidence | [Blood Flow Restriction Cuffs](https://magellanlongevity.com/p/173.md) |

## Reference

1. **Resistance training with blood flow restriction on muscle strength and hypertrophy in arthritis: a meta-analysis**
   PLoS One 2021 · [PMID 34758045](https://pubmed.ncbi.nlm.nih.gov/34758045/) · [DOI 10.1371/journal.pone.0259574](https://doi.org/10.1371/journal.pone.0259574)

   > blood flow restriction training is a promising strategy for gains in muscle strength, mass and functionality

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## Scope and disclosures

Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication.

Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases.

Reviewed for accuracy by a board-certified physician (DO).