Effects of Blood Flow Restriction Training on Muscle Strength and Physical Function in Older Adults With Sarcopenia
Abstract
Objective
To investigate the effects of blood flow restriction (BFR) training on muscle strength, physical function, functional mobility, and activities of daily living (ADL) in hospitalized older adults with sarcopenia, and to compare its efficacy with that of traditional resistance training (RT), thereby providing a research basis for the development of clinical rehabilitation strategies.
Methods
In this randomized controlled trial, 40 hospitalized older adults clinically diagnosed with sarcopenia were enrolled. By using a computer-generated randomization sequence, the participants were randomly assigned at a 1∶1 ratio to an experimental group (n = 20) receiving BFR training or a control group (n = 20) receiving RT. Both groups underwent a 12-week supervised program, with training sessions conducted 3 times per week. Outcome measures were assessed at baseline, 4 weeks, and 12 weeks. The primary outcome measure was muscle strength, assessed by dominant-hand grip strength. Secondary outcomes included physical function assessed with the Short Physical Performance Battery (SPPB), functional mobility assessed by the 6-meter (6-m) gait speed and the Timed Up and Go (TUG) test, and ADL assessed with the Modified Barthel Index (MBI).
Results
No participants were lost to follow-up, and no adverse events were reported. After 4 weeks of intervention, grip strength improved significantly in both groups compared with the baseline data (all P < 0.001), with the BFR group demonstrating higher grip strength than the RT group ([24.35 ± 5.43] kg vs [20.96 ± 5.25] kg), although the between-group difference was not statistically significant (P = 0.051). Regarding secondary outcomes, the BFR group showed significant improvements in SPPB and MBI scores compared with the RT group (all P < 0.05), with the most pronounced differences in TUG performance and 6-m gait speed (P < 0.01). After 12 weeks of intervention, grip strength was significantly higher in the BFR group than that in the RT group ([25.25 ± 5.34] kg vs. [21.66 ± 5.19] kg; P = 0.039). Moreover, the BFR group demonstrated significantly better outcomes in SPPB score, 6-m gait speed, TUG time, and MBI score than the RT group did (all P < 0.01).
Conclusion
BFR training significantly improves muscle strength, physical function, functional mobility, and ADL in hospitalized older adults with sarcopenia, showing superior efficacy compared with conventional RT.
Keywords: Blood flow restriction training, Sarcopenia, Muscle strength, Elderly patient
Full Text:
PDFReferences
Cruz-Jentoft A J, Sayer A A. Sarcopenia[J]. Lancet, 2019, 393(10191): 2636-2646. DOI: 10.1016/s0140-6736(19)31138-9.
Fanny P R, Viktoria B, Stuart R G, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis [J]. J Cachexia Sarcopenia Muscle, 2021, 13(1). DOI: 10.1002/jcsm.12783.
Chen L K, Hsiao F Y, Akishita M, et al. A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update[J]. Nat Aging, 2025, 5(11): 2164-75. DOI: 10.1038/s43587-025-01004-y.
Jang J Y, Kim D, Kim N D. Pathogenesis, intervention, and current status of drug development for sarcopenia: a review [J]. Biomedicines, 2023, 11(6). DOI: 10.3390/biomedicines11061635.
Guo Q, Zhang Y Y, Wang L, et al. Research progress on adverse clinical outcomes of sarcopenia[J]. Journal of Practical Hospital Clinical Medicine, 2024, 21(4): 172-175. DOI: 10.3969/j.issn.1672-6170.2024.04.039.
Chen X Z, Long H C. Research progress on intervention treatment for sarcopenia in elderly patients with chronic obstructive pulmonary disease[J]. Journal of Practical Hospital Clinical Medicine, 2025, 22(4): 201-205. DOI: 10.3969/j.issn.1672-6170.2025.04.040.
Shen Y, Shi Q, Nong K, et al. Exercise for sarcopenia in older people: a systematic review and network meta-analysis[J]. J Cachexia Sarcopenia Muscle, 2023, 14(3): 1199-1211. DOI: 10.1002/jcsm.13225.
Yasuda T. Selected methods of resistance training for prevention and treatment of sarcopenia [J]. Cells, 2022, 11(9). DOI: 10.3390/cells11091389.
Sasaki K I, Fukumoto Y. Sarcopenia as a comorbidity of cardiovascular disease[J]. J Cardiol, 2022, 79(5): 596-604. DOI: 10.1016/j.jjcc.2021.10.013. Yuan J, Wu L, Xue Z, et al. Application and progress of blood flow restriction training in improving muscle mass and strength in the elderly[J]. Front Physiol, 2023, 14: 1155314. DOI: 10.3389/fphys.2023. 1155314.
Liu X C, Zhang T T, Zhu S J, et al. Relationship between sarcopenia and cognitive impairment in elderly stroke patients[J]. Journal of Practical Hospital Clinical Medicine, 2025, 22(6): 89-93. DOI: 10.3969/j.issn.1672-6170.2025.06.017.
Chen N, He X, Zhao G, et al. Efficacy of low-load resistance training combined with blood flow restriction vs. high-load resistance training on sarcopenia among community-dwelling older Chinese people: study protocol for a 3-arm randomized controlled trial[J]. Trials, 2021, 22(1): 518. DOI: 10.1186/s13063-021-05495-z.
Chen L K, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020, 21(3): 300-7.e2. DOI: 10.1016/j. jamda.2019.12.012.
Geriatrics Branch of Chinese Medical Association, National Clinical Research Center for Geriatric Diseases (Xiangya Hospital). Chinese Guidelines for Diagnosis and Treatment of Sarcopenia (2024 Edition)[J]. Chinese Medical Journal, 2025, 105(3): 181-203. DOI: 10.3760/cma.j. cn112137-20240724-0170.
Pan C L, Yang L, Li X N, et al. Research progress on methods for determining resistance exercise load in the elderly[J]. Journal of Nursing Research, 2024, 38(23): 4282-4288. DOI: 10.12102/j.issn.1009-6493.2024.23.025.
Parkington T, Maden-Wilkinson T, Klonizakis M, et al. Comparative perceptual, affective, and cardiovascular responses between resistance exercise with and without blood flow restriction in older adults [J]. Int J Environ Res Public Health, 2022, 19(23). DOI: 10.3390/ijerph192316000.
Peng N, Miao D, Wang H, et al. Application effect of baduanjin combined with blood flow restriction training on elderly sarcopenia[J]. Chinese Journal of Health Care Medicine, 2024, 26(3): 332-335. DOI: 10.3969/j. issn.1674-3245.2024.03.019.
Wang X, Li N, Liang S Y, et al. Summary of best evidence for blood flow restriction training in elderly patients with sarcopenia[J]. Chinese Journal of Nursing, 2024, 59(10): 1187-1194. DOI: 10.3761/j.issn.0254-1769.2024.10.005.
Praetorius A. Blood flow restriction training (BFRT) in patients before and after total knee arthroplasty[J]. Orthopadie (Heidelb), 2024, 53(11): 853-857. DOI: 10.1007/s00132-024-04543-1.
Piskin N E, Aktug Z B, Kara M, et al. The effect of blood flow restriction training on isokinetic strength muscle thickness and athletic performance[J]. J Musculoskelet Neuronal Interact, 2025, 25(2): 208-218. DOI: 10.22540/jmni-25-208.
Liang Y X, Wang R J, Jiang J J, et al. Effect of Otago exercise on activities of daily living in elderly patients with sarcopenia[J]. Journal of Sichuan University (Medical Sciences), 2025, 56(2): 543-548. DOI: 10.12182/ 20250360608.
Sinnott M J, Schneider N, Vanguri P. Effects of blood flow restriction training on the upper extremities: a scoping review[J/OL]. Cureus, 2025, 17(3): e79876. https://www.cureus.com/articles/322583-effects-of-blood-flow-restriction-training-on-the-upper-extremities-a-scoping-review#!/. DOI: 10.7759/cureus.79876.
Zhang M, Song Y, Zhu J, et al. Effectiveness of low-load resistance training with blood flow restriction vs. conventional high-intensity resistance training in older people diagnosed with sarcopenia: a randomized controlled trial[J]. Sci Rep, 2024, 14(1): 28427. DOI: 10.1038/s41598-024-79506-9.
Cahalin L P, Formiga M F, Anderson B, et al. A call to action for blood flow restriction training in older adults with or susceptible to sarcopenia: a systematic review and meta-analysis[J]. Front Physiol, 2022, 13: 924614. DOI: 10.3389/fphys.2022.924614.
Zhang X Z, Xie W Q, Chen L, et al. Blood flow restriction training for the intervention of sarcopenia: current stage and future perspective[J]. Front Med (Lausanne), 2022, 9: 894996. DOI: 10.3389/fmed.2022.894996.
Shi X K, Feng X D. Research progress on exercise-regulated programmed cell death in the prevention and treatment of sarcopenia[J]. Journal Of Sun Yat-sen University (Medical Sciences), 2025, 46(5): 737-746. DOI: 10. 13471/j.cnki.j.sun.yat-sen.univ(med.sci).2025.0503.
Zhao W, Ukawa S, Tsushita K, et al. Association of gait speed with mortality among the Japanese elderly in the New Integrated Suburban Seniority Investigation Project: a prospective cohort study[J]. Age Ageing, 2015, 44(1): 153-157. DOI: 10.1093/ageing/afu121.
de Smet R, Brys A D H, Calders P, et al. Implementation of blood flow restriction training in the acute geriatric unit [J/OL]. Age Ageing, 2025, 54(10):afaf315. https://academic.oup.com/ageing/article/54/10/afaf315/ 8303973. DOI: 10.1093/ageing/afaf315.
Middleton A, Fulk G D, Herter T M, et al. Self-selected and maximal walking speeds provide greater insight into fall status than walking speed reserve among community-dwelling older adults[J]. Am J Phys Med Rehabil, 2016, 95(7): 475-482. DOI: 10.1097/phm.0000000000000488.
Refbacks
- There are currently no refbacks.



