Evidence map›Paper›PMID 42888637›Full record

SynthesisMedicine2026

Effects of blood flow restriction training in adult upper-limb musculoskeletal rehabilitation: A systematic review.

Lama Saif Khan, Abdulelah K Alqawlaq, Majd Hussain Almech, Abdulaziz Khalid Alaryani, Yousef I Alhusaini, Adnan Alaa Sultan, Fouad Turki Alnajjar, Abdullah Mohammed Falqi, Wahib Shehab Alshaibani, Mohamed Ibrahim Hassan and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Lama Saif KhanEmergency Medical Services, Medical Fakeeh, Jeddah, Saudi Arabia.
Abdulelah K AlqawlaqGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.ORCID 0009-0006-7844-8288
Majd Hussain AlmechGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Abdulaziz Khalid AlaryaniCritical Care in Emergency Medical Service, Johns Hopkins Aramco Healthcare, Abqaiq, Saudi Arabia.
Yousef I AlhusainiCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Adnan Alaa SultanGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Fouad Turki AlnajjarGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Abdullah Mohammed FalqiGeneral Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia.
Wahib Shehab AlshaibaniDepartment of Orthopedic Surgery, International Medical Center, Jeddah, Saudi Arabia.
Mohamed Ibrahim HassanDepartment of Orthopedic Surgery, International Medical Center, Jeddah, Saudi Arabia.
Ramy SamargandiDepartment of Orthopedic Surgery, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Maan JamjoomCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBlood flow restriction training (BFRT) has been proposed as a low-load rehabilitation strategy for symptomatic and postoperative upper-limb musculoskeletal conditions. This review evaluated the clinical effects, tolerability, and prescription characteristics of BFRT in adult upper-limb musculoskeletal rehabilitation.

methodsThis systematic review was registered in International Prospective Register of Systematic Reviews (CRD420261299726) and reported with reference to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. CENTRAL/Cochrane Library, Embase via Ovid, MEDLINE/PubMed, Science Citation Index/Web of Science, and Scopus were searched without a start-date restriction before February 18, 2026; backward reference-list/citation checking was also used. Randomized trials, case series, and case reports were eligible. Findings were synthesized narratively because of heterogeneity, and studies were appraised using risk of bias 2 or design-appropriate Joanna Briggs Institute checklists.

resultsTwenty reports were included: 9 parallel-group randomized trials, 1 randomized crossover trial, 2 case series, and 8 case-report publications. Across the reports, 340 participants were enrolled or randomized and 326 contributed to the analyzed/treated clinical samples; 158 were men (48.5%) and 168 were women (51.5%). In a sham-controlled lateral elbow tendinopathy trial, BFRT resulted in a significantly greater reduction in 12-week pain (between-group difference -1.54, 95% confidence interval [CI] -2.89 to -0.18; P = .026) and patient-rated tennis elbow evaluation (PRTEE) (-15.23, 95% CI -23.57 to -6.90; P < .001). In patients with chronic lateral epicondylitis, PRTEE reduction (-24.20 ± 4.02 vs -15.60 ± 3.71; P = .001) and quick disabilities of the arm, shoulder and hand reduction (-12.83 ± 4.97 vs -7.51 ± 4.72; P = .025) were significantly greater with BFRT plus conventional therapy, whereas between-group pain and strength changes were not significant. In nonoperative distal-radius-fracture rehabilitation, mean activity-pain reduction was 4.0 versus 2.3 points (P = .03). In rotator-cuff tendinopathy, BFRT resulted in significantly greater biceps thickness (P = .002) and internal-rotation strength (P = .040). Conversely, a pragmatic elbow trial found no significant between-group difference in 12-month PRTEE (adjusted contrast + 4.32, 95% CI -9.17 to 17.81; P = .53).

conclusionBFRT may be considered a low-load adjunct in adult upper-limb musculoskeletal rehabilitation settings, but it is not consistently superior to active rehabilitation for pain, strength, or function. Confidence remains limited by small samples, heterogeneous prescriptions and co-interventions, uncontrolled designs, and incomplete adverse-event ascertainment.

Indexed as

Blood Flow Restriction TherapyMusculoskeletal DiseasesUpper ExtremityAdultFemaleHumansMaleRandomized Controlled Trials as Topicblood flow restriction trainingdistal radius fracturehand osteoarthritisLateral elbow tendinopathypostoperative rehabilitationrotator cuff tendinopathyupper-limb musculoskeletal rehabilitation

Identifiers

PMID42888637
PMCPMC13681137

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.