Effects of blood flow restriction and resistance training on bone health biomarkers and bone mineral density: a systematic review and meta-analysis

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in medical sciences Pub Date : 2026-09-01 Epub Date: 2026-10-06 DOI:10.1016/j.advms.2026.10.001

Gustavo Dias Bottari, Giulianna Faypher Morena Vieira da Silva, Tamy Colonetti, Maria Inês da Rosa, Fernanda Marçal de Lago, Joni Márcio de Farias, Antonio Jose Grande

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引用次数: 0

Abstract

Purpose

Low-intensity resistance training combined with blood flow restriction (LIBFR) has been proposed as an alternative to conventional resistance training, but its effects on bone metabolism remain unclear. This review compared LIBFR with high-intensity resistance training (HIRT), low-intensity resistance training (LIRT) and non-exercise on bone formation and resorption markers and bone mineral density (BMD).

Methods

MEDLINE (PubMed), Cochrane Library (CENTRAL), EMBASE, APA and Global Health (EBSCO) were searched up to 20th May 2026 for clinical trials in adults assessing bone-specific alkaline phosphatase (BSAP), cross-linked C-telopeptides of type I collagen (CTX-I) or BMD. Risk of bias was assessed with RoB 2 and certainty of evidence with GRADE. Meta-analyses were performed where applicable.

Results

Eight studies (nine reports; n = 211 participants) were included. Compared with HIRT, LIBFR resulted in significantly lower BSAP (MD = −2.72 [95% CI −5.17 to −0.28]) and CTX-I (MD = −0.08 [95% CI −0.13 to −0.03]), with no difference in BMD. Compared with LIRT, BSAP and CTX-I did not differ, but BMD was significantly higher in a single study (MD = 0.04 [95% CI 0.03 to 0.05]). Compared with non-exercise, LIBFR significantly reduced CTX-I and BMD, with no difference in BSAP. The certainty of evidence was very low for all comparisons.

Conclusion

LIBFR reduced BSAP and CTX-I compared with HIRT, and CTX-I compared with non-exercise. BMD findings were mixed: higher versus LIRT, similar versus HIRT and lower versus non-exercise. Given the very low certainty of evidence, these findings should be interpreted with caution.

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血流限制和阻力训练对骨健康生物标志物和骨矿物质密度的影响：一项系统综述和荟萃分析

目的：低强度阻力训练联合血流限制（LIBFR）已被提出作为常规阻力训练的替代方案，但其对骨代谢的影响尚不清楚。本综述比较了LIBFR与高强度阻力训练（HIRT）、低强度阻力训练（LIRT）和非运动对骨形成和吸收指标以及骨矿物质密度（BMD）的影响。方法：检索MEDLINE （PubMed）、Cochrane Library （CENTRAL）、EMBASE、APA和Global Health (EBSCO)，检索截至2026年5月20日的成人骨特异性碱性磷酸酶（BSAP）、I型胶原交联c端肽（CTX-I）或BMD的临床试验。偏倚风险用RoB 2评估，证据确定性用GRADE评估。在适用的地方进行meta分析。结果：纳入8项研究（9篇报道，n=211名受试者）。与HIRT相比，LIBFR导致BSAP （MD = -2.72 [95% CI -5.17至-0.28]）和CTX-I （MD = -0.08 [95% CI -0.13至-0.03]）显著降低，BMD无差异。与LIRT相比，BSAP和CTX-I没有差异，但BMD在单个研究中显著升高（MD = 0.04 [95% CI 0.03 ~ 0.05]）。与不运动相比，LIBFR显著降低CTX-I和BMD， BSAP无差异。所有比较的证据的确定性都很低。结论：与HIRT相比，LIBFR降低了BSAP和CTX-I，与非运动相比，CTX-I降低了。BMD的研究结果是混合的：与LIRT相比更高，与HIRT相似，与非运动相比更低。鉴于证据的确定性非常低，这些发现应谨慎解释。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.