Use of Blood Flow Restriction Training Between North American Sports Medicine Practitioners: A Questionnaire-Based Survey

Research Objectives: To profile current clinical application of blood flow restriction (BFR) training among active sports medicine practitioners in North America using an online questionnaire. To compare responses to position stand recommendations regarding BFR training methodology.

Design: Survey distributed through August and September of 2021.

Setting: Online.

Participants: Convenience sample of 72 clinicians actively practicing in the United States (n=67) and Canada (n=5) were included. Experience applying or prescribing BFR training was required. Individuals unfamiliar with written English were excluded. The survey link was distributed electronically through professional organizations, email list servs, and social media.

Interventions: Not applicable.

Main Outcome Measures: Demographics (profession, practice setting, years of experience), type of equipment, treatment parameters, observed side effects, and personal opinions on the efficacy and value of BFR training.

Results: Athletic trainers (48.6%) and physical therapists (41.7%) primarily completed the survey. Automatic inflated cuffs and KAATSU airbands were the most common units employed. Parameters varied between respondents for exercise prescription (e.g. load and volume) and occlusion settings. Populations for BFR implementation ranged from injured (93.1%) and post-surgery cases (88.4%) to healthy individuals for performance enhancement (9.4%). Respondents primarily followed position statement recommendations with individualized pressure selections specific to blood pressure for resistance (80.9%) and aerobic BFR (69.6%) modes. Side effects reported included delayed onset muscle soreness (66.2%), inability to continue treatment due to pain (28%), numbness (22.5%), and cold feeling in the extremity (19.7%). Physical therapists indicated higher confidence in safety (t= -2.291, p=0.026), understanding of practice recommendations (t= -2.615, p=0.011) and theoretical principles (t=-3.056, p=0.004) compared with athletic trainers.

Conclusions: BFR is a common modality in contemporary sports medicine settings. Variations in BFR application is evident in devices, exercise and occlusion parameters selected, and side effects observed. Practitioners appear to be compliant with practice recommendations regarding the adoption of individualized pressure prescription.

Author(s) Disclosures: N/A.