The primary aim of this study was to systematically compare the effectiveness of blood flow restriction training (BFR) versus traditional resistance training (TRT) to improve muscle size in healthy adults. Secondary outcomes were improvements in muscle strength and endurance. We performed a systematic searchwithmeta-analysis. Using predetermined criteria, 541 unique articles were identified through databases and bibliographies. After screening titles, abstracts, and full texts, 20 articles were included in the review. All 20 articles evaluated muscle hypertrophy, 19 evaluated strength, and 1 evaluated endurance in response to BFR and TRT. Data from 10 articles were included in the meta-analysis. In the qualitative analysis, TRT and BFR increased muscle size without differences between conditions for at least 1 hypertrophy outcome in 13 studies, and TRT or BFR differentially improved hypertrophy in 5 studies. TRT and BFR increased strength without differences between conditions for at least 1 outcome in 15 studies, and TRT or BFR differentially improved strength in 9 studies. Results from the meta-analysis indicate no differences in muscle size (ES 5 0.045, 95% CI [20.278 to 0.367]) or strength (ES520.149, 95% CI [20.439 to 0.141]) improvements with BFR versus TRT. Practitioners can implement BFR training to increase muscle size and strength as appropriate, especially for training periods of 8 weeks or longer.

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