血流限制训练法联合抗阻训练对运动者肌肉相关指标影响的Meta分析

Effects of blood flow restriction training combined with resistance training on muscle indicators in college athletes:a meta-analysis

目的:通过收集血流限制训练法联合抗阻训练的相关文献,依照系统评价和Meta分析的范式,分析血流限制训练法联合抗阻训练与抗阻训练对运动者肌肉相关指标和专项能力的不同影响,旨在为运动者在训练实践中运用血流限制训练提供数据支持。方法:检索中外数据库(中国知网、万方、PubMed、Web of Science和SPORTDiscus),应用血流限制训练法联合抗阻训练对对象为运动者中大学生运动者肢体围度、肌肉质量、肌肉力量和专项运动能力影响的随机对照试验,检索起止时间为2000-01-01/2023-10-12。至少2名研究者采用Cochrane协作网偏倚风险评估工具和标准对纳入文献进行质量评价。使用RevMan 5.4软件进行异质性检验、数据合并、亚组分析、绘制森林图和敏感性分析,绘制漏斗图并进行发表偏倚评价和敏感性分析。评价指标为肢体围度、肌肉厚度、肌肉力量和专项能力等,对不同专项运动能力进行亚组分析。结果:①共纳入18项随机对照试验,共403例受试者,根据Cochrane协作网偏倚风险评估工具,纳入文献中文献质量为A级的有16篇,B级有2篇。②将血流限制训练法联合抗阻训练与抗阻训练之间的效果进行对比,在肢体围度方面,两组间无显著性差异(SMD=0.03,95%CI:-0.16-0.21,P=0.78);在肌肉厚度方面(SMD=0.14,95%CI:0.01-0.27,P=0.03)及肌肉力量方面(SMD=0.37,95%CI:0.14-0.60,P=0.001)两组间有显著性差异。③对专项能力指标进行亚组分析结果显示,距离指标的分析结果存在高异质性(I2=73%),时间指标的分析结果存在高异质性(I2=55%),分析可能原因是各研究的测试方法及评估指标意义的不同导致;功率指标的分析结果显示无异质性(I2=0%);血流限制训练法联合抗阻训练对距离指标具有显著影响(P<0.01)。④合并效应结果显示,血流限制训练法联合抗阻训练比较抗阻训练对于专项能力的影响(P=0.41),提示不同训练方法对于专项能力不存在显著性影响。结论:①两种训练方法均能够促进大学生运动者的肌肉厚度、肌肉力量和专项能力,血流限制训练法联合抗阻训练相较于抗阻训练在促进运动员肌肉厚度、肌肉力量和部分专项能力方面具有显著性效果。因此,可以在专项训练之中科学合理地融合血流限制训练法,以差异性的生理刺激综合作用于肌肉,以取得更好的训练效果。②然而,由于纳入的研究数量较少,以及其他可能存在的局限性,今后需要纳入更多的高质量、多项目类型和性别的随机对照试验来证实。

OBJECTIVE:This paper collects relevant literature on blood flow restriction training combined with resistance training,and analyzes the different effects of blood flow restriction training combined with resistance training on athletes’muscle-related indexes and specialized abilities in accordance with the paradigm of systematic evaluation and Meta-analysis,aiming to provide data support for athletes to utilize blood flow restriction training in their training practices.METHODS:Chinese and foreign databases(CNKI,WanFang,PubMed,Web of Science,SPORTDiscus)were searched to collect randomized controlled trials on the effects of blood flow restriction training combined with resistance training on limb circumference,muscle mass,muscle strength,and specialized ability of college athletes from January 1st,2000 to October 12th,2023.At least two researchers evaluated the quality of the included literature using the Cochrane Collaboration risk of bias assessment tools and criteria.Heterogeneity tests,data merging,subgroup analyses,forest plotting,and sensitivity analyses were performed using RevMan 5.4,and funnel plots with publication bias evaluation and sensitivity analyses were performed.The evaluation indexes were limb circumference,muscle thickness,muscle strength and specialized ability,and subgroup analyses were performed for different specialized athletic abilities.RESULTS:(1)A total of 18 randomized controlled trials with 403 subjects were included,and according to the Cochrane Collaboration’s risk of bias assessment tool,the quality of literature in the included literature was grade A in 16 articles and grade B in 2 articles.(2)Comparing the effects of blood flow restriction training combined with resistance training and resistance training,there was no significant difference between the two groups in terms of limb circumference[standardized mean difference(SMD)=0.03,95%confidence interval:-0.16-0.21,P=0.78],and a significant difference between the two groups in terms of muscle thickness(SMD=0.14,95%CI:0.01-0.27,P=0.03)and muscle strength(SMD=0.37,95%CI:0.14-0.60,P=0.001).(3)Subgroup analyses of the indicators of specialized capacity indicated that there was high heterogeneity in the analyzed results of distance metrics(I2=73%)and time metrics(I2=55%),which was analyzed as a possible reason due to the differences in testing methods and assessment of metrics’significance in the studies;there was no heterogeneity(I2=0%)in the analyzed results of power metrics;blood flow restriction training combined with resistance training had a significant effect on distance metrics(P<0.01).(4)The results of the combined effect showed the effect of blood flow restriction training combined with resistance training vs.resistance training for specialized ability(P=0.41),suggesting that there is no significant effect of different training methods on specialized ability.CONCLUSION:Both blood flow restriction training combined with resistance training and resistance training can promote muscle thickness,muscle strength and specialized ability in college athletes.Meanwhile,blood flow restriction training combined with resistance training has a more significant effect on muscle thickness,muscle strength and some specialized abilities compared with resistance training.Therefore,blood flow restriction training can be scientifically and rationally integrated into specialized training,so as to achieve a better training effect by integrating the differentiated physiological stimuli to the muscles.However,due to the small number of included studies and other possible limitations,more high-quality,multi-sport type and sex randomized trials need to be included in the future to confirm this.