The effects of Low- to Low-Moderate Intensity Aerobic Exercise with Blood Flow Restriction on Cardiorespiratory Fitness in Healthy People: A Critical Systematic Review and Meta-Analysis

Abstract

While low intensity aerobic exercise is not capable of improving cardiorespiratory fitness (VO2max), high intensity aerobic exercise may not be appropriate in some cases. Therefore, low- to low-moderate intensity aerobic exercise with Blood Flow Restriction (BFR) could offer a solution by providing a low mechanical stimulus and still obtaining improvements in VO2max. The main objective of this systematic review and meta-analysis was to investigate the effects of low- to low-moderate intensity aerobic exercise with BFR on VO2max in healthy people. The literature search yielded seven studies in total. All were included in the systematic review. Five were included in the meta-analysis. This provided data of 168 and 73 participants, respectively. The final risk of bias was judged as ‘some concerns’ for all studies. The overall effect of low- to low-moderate intensity aerobic exercise with BFR on VO2max was statistically significant (Z = 7.22; p < 0.00001) with a mean difference of 3.16 ml/kg/min [95% CI = 2.30, 4.01]. Elite athletes, healthy adults and all exercise types and modalities showed a significant improvement in VO2max. This meta-analysis shows that low- to low-moderate intensity aerobic exercise with BFR can offer a solution to improve VO2max in cases where high intensity exercise is not appropriate. Due to the small amount of studies included, conclusions should be made with caution.