Efectividad de la restricción del flujo sanguíneo en tendones de extremidades inferiores: una revisión sistemática

Introduction: Lower limb tendinopathy is a common condition that leads to pain and functional limitations, particularly among physically active individuals. While high-load training promotes tendon adaptation, its early use in rehabilitation may aggravate symptoms. Blood flow restriction (BFR) training has emerged as a promising low-load alternative. Objective: To evaluate the effectiveness of BFR training on the structural and functional properties of lower limb tendons through a systematic review of controlled clinical trials. Methodology: Following PRISMA guidelines, five databases were searched up to March 2025. Five controlled clinical trials involving 232 participants with and without tendinopathy were included. Methodological quality was assessed using the Cochrane RoB 2 tool and the PEDro scale. Interventions involved low-load resistance exercise (20–35% 1RM) combined with BFR, compared against high-load training or no intervention. Results: Studies reported significant improvements in tendon thickness, cross-sectional area, and muscle strength with low-load BFR training. These outcomes were generally comparable to high-load protocols. However, acute responses varied across studies, with inconsistent changes in tendon thickness observed post-exercise. Discussion: BFR training appears to promote structural and functional improvements without requiring high loads, although more consistent studies are needed to standardize protocols and outcomes. Conclusion: BFR is a promising strategy for managing lower limb tendinopathies, especially when high-load exercise is contraindicated. More robust studies are needed to standardize protocols and explore long-term benefits in both clinical and athletic populations.