Effects of blood flow restriction combined with interval training on aerobic capacity, anaerobic performance, and sport-specific performance in trained male athletes: a systematic review and meta-analysis.

This systematic review and meta-analysis evaluated the effects of blood flow restriction (BFR) combined with interval training on aerobic capacity, anaerobic performance, and sport-specific performance in trained male athletes. We searched Cochrane Library, SPORTDiscus via EBSCO, Embase, PubMed, Scopus, and Web of Science from inception to 15 May 2026. Eligible studies were randomized controlled, randomized crossover, or paired randomized trials comparing BFR plus interval-type training with interval training without BFR in trained athletes. Fifteen reports representing 13 independent studies were included. Data were synthesized using pre-post change scores. Effects were expressed as Hedges' g standardized mean differences and pooled with random-effects models. Risk of bias was assessed with RoB 2, certainty of evidence with GRADE, and moderator effects with subgroup and sensitivity analysis. The searches identified 626 records. After removing 379 duplicates, 247 records were screened; 223 were excluded at title/abstract screening and 24 were retained for full-text assessment. BFR combined with interval training showed small statistically significant additional benefits for aerobic capacity (g = 0.30, 95% CI 0.05 to 0.55), anaerobic performance (g = 0.32, 95% CI 0.05 to 0.59), and sport-specific performance (g = 0.44, 95% CI 0.14 to 0.74). All included study-level samples were male. Statistical heterogeneity was low across primary analyses. Formal subgroup analysis did not show statistically significant subgroup differences, and sensitivity analysis did not materially change the direction of the primary findings. RoB 2 judgments were low risk for 1 study, some concerns for 11 studies, and high risk for 1 study. GRADE certainty was low for all three primary outcomes. In trained male athletes, BFR combined with interval training may provide small additional benefits for aerobic capacity, anaerobic performance, and sport-specific performance. However, the low certainty of evidence, uncertain practical significance, heterogeneous BFR prescriptions, and insufficient safety reporting do not support its immediate widespread adoption as a primary performance-enhancement strategy.