血流限制下耐力训练对有氧能力和下肢肌力及运动表现影响的Meta分析

Effects of endurance training with blood flow restriction on aerobic capacity,lower limb muscle strength,and sports performance:a Meta-analysis

目的:采用Meta分析方法系统评价血流限制下耐力训练对运动员有氧能力、下肢肌力和运动表现的影响。方法:截至2023年3月,在CNKI、维普、万方及PubMed、Embase、Web of Science、Science Direct、Cochrane数据库中检索文献,得到3210篇文献,筛选后共纳入12篇文献,共14份研究报告。使用Review Manager 5.4和Stata 14软件进行Meta分析。结果:血流限制下耐力训练对运动员最大摄氧量具有中等效应(SMD=0.59,95%CI:0.28-0.90,P<0.05)且无异质性。持续加压类型的效果要优于其他加压类型(P<0.05);训练内容采用有氧耐力练习较无氧速耐练习效果更优(P<0.05);4-8周、每周3次及以上、20-30 min/次以及总训练次数12次以上效果更好。其次,血流限制下耐力训练对下肢肌力具有大效应(SMD=0.99,95%CI:0.61-1.37,P<0.05)且无异质性,亚组分析结果显示肌肉耐力提升效果最好(SMD=1.11;95%CI:0.37-1.85),其次为伸膝力量(SMD=1.02,95%CI:0.37-1.67)、屈膝力量(SMD=0.87,95%CI:0.24-1.51)。最后,血流限制下耐力训练对运动表现具有中等效应(SMD=0.59,95%CI:0.13-1.06,P<0.05),亚组分析结果显示跑步表现(SMD=0.55,95%CI:0.05-1.06,P<0.05)且无异质性,足球专项运动表现仅1项,未合并分析。结论:血流限制下耐力训练可以提高运动员有氧能力、下肢肌力和运动表现,其中下肢肌力达到大效应,有氧能力和运动表现为中等效应。采用持续性加压且不低于4周,3次/周,20-30 min/次,总次数12次以上的渐进式混合强度有氧耐力练习的训练安排,易于获得更佳的训练效果。

OBJECTIVE:To systematically assess the effect of blood flow restriction combined with endurance training on aerobic capacity,lower limb muscle strength,and sports performance of athletes using Meta-analysis.METHODS:3210 studies were searched in CNKI,VIP,WanFang,PubMed,Embase,Web of Science,ScienceDirect,and Cochrane databases before March 2023.After screening,12 studies and 14 research reports were included.The traditional Meta-analysis and network Meta-analysis were performed by Review Manager 5.4 and Stata 14.RESULTS:Endurance training with blood flow restriction had a medium effect size on maximal oxygen uptake(standardized mean difference(SMD)=0.59,95%confidence interval(CI):0.28-0.90,P<0.05)and no heterogeneity.The effect of continuous pressure was better than the other pressure types(P<0.05).Compared with sports events by anaerobic energy supply,sports events by aerobic energy supply showed better effects(P<0.05),which was set as follows:4-8 weeks of aerobic training,20-30 minutes once,3 or more sessions per week,for a total of 12 or more sessions.Secondly,endurance training with blood flow restriction showed a large effect on the lower limb muscle strength(SMD=0.99,95%CI:0.61-1.37,P<0.05)and no heterogeneity.A subgroup analysis showed muscle endurance was the best improved(SMD=1.11;95%CI:0.37-1.85),followed by knee extension strength(SMD=1.02,95%CI:0.37-1.67)and knee flexion strength(SMD=0.87,95%CI:0.24-1.51).Finally,endurance training with blood flow restriction showed a medium effect on sports performance(SMD=0.59,95%CI:0.13-1.06,P<0.05),and the subgroup analysis showed a medium effect on running performance(SMD=0.55,95%CI:0.05-1.06,P<0.05)and no heterogeneity.There was only one item of soccer specific performance that was not analyzed.CONCLUSION:Endurance training combined with blood flow restriction can improve the aerobic capacity,lower limb muscle strength,and sports performance of the athletes.And there is a large effect on lower limb muscle strength and a medium effect on aerobic capacity and sports performance.A training schedule of progressive mixed-intensity aerobic endurance training under continuous pressure for no less than 4 weeks,3 sessions per week,20-30 minutes per session,for 12 or more sessions in total is easy to obtain better training results.