Effects of Blood Flow Restriction Training on Muscular Adaptations among Fitness Enthusiasts: A Scoping Review

Introduction: Blood Flow Restriction (BFR) training has proved to be a viable option to cause muscular adaptations under low loads, thus ideal for persons who cannot tolerate highresistance training. By creating external pressure that limits venous return with continued arterial inflow, BFR causes local hypoxia, metabolic stress, and enhanced recruitment of muscle fibres. These physiological processes create adaptations equivalent to high-intensity training, which has endeared BFR as a valuable option for athletes and fitness enthusiasts seeking to enhance performance with less mechanical tension on joints and tissues. Aim: To examine the effect of BFR on muscular strength, hypertrophy, endurance, and aerobic capacity in healthy, active subjects. Materials and Methods: A scoping review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Review Extension (PRISMA-ScR ) guidelines, for a period of six months i.e., from February 2025 to July 2025. Electronic databases such as PubMed, Scopus, Web of Science, and Sports Documentation and Information Service were searched for peer-reviewed English-language articles from inception until 2025. Eligible studies were experimental and observational designs that studied BFR in recreationally active healthy adults. A total of 25 Randomised Controlled Trials (RCTs) were included after screening. Results: BFR training improved muscle strength and hypertrophy in all age groups and training backgrounds with consistency. Such improvements were present even at low intensities {(20- 30%, one Reptition Maximum (1RM)}, where the results were often as good as high-load training. A number of studies also showed that muscular endurance and systemic adaptations, including cross-education effects, were improved. Aerobic capacity and vascular function outcomes were inconsistent with probable protocol differences. BFR exercise was safe and tolerated well, with minor and transient side-effects. Personalised occlusion pressures and training loads optimised safety and efficacy. Conclusion: BFR is a potent, low-load training modality that increases strength, hypertrophy, and muscular endurance in healthy individuals. It provides a joint-sparing intervention for those with load constraints and has future potential in sport and rehabilitation. Standardisation of training parameters and additional research on long-term adaptations, gender differences, and ideal pressure values are required to further develop its clinical and sporting application.