# Trends and Practices on Blood Flow Restriction Training Are Not Largely Aligned With the Contemporary Evidence

## TL;DR

Physiotherapists use blood flow restriction training in ways that often don't match current scientific evidence.

## Contribution

This study reveals a mismatch between physiotherapists' BFRT practices and current scientific guidelines.

## Key findings

- Physiotherapists show confidence in BFRT but use varied methods not aligned with evidence.
- Most BFRT is used for musculoskeletal conditions to improve strength and muscle volume.
- Training practices vary widely in pressure calculation, reperfusion schemes, and exercise numbers.

## Abstract

Objective: To evaluate trends and current clinical practice of physiotherapists on blood flow restriction training (BFRT) application.

Methods: An online survey was conducted to assess: a) demographics and professional characteristics, b) specifics of BFRT application, and c) safety and adverse events. We tested using Pearson’s Chi-square test whether the physiotherapist's characteristics were independent of their years of experience and formal BFR education.

Results: Most respondents reported having much confidence (n=47, 44.6%) in using BFRT, and they used it for a mean of 2.6±1.7 years. Significant variability among respondents was found in devices used, limb occlusion pressure calculation methods, the reperfusion scheme, the number of exercises implemented, and the percentage of complete occlusion pressure used for exercising. Most used BFRT in musculoskeletal conditions of the upper and lower limb (n=88, 86.3%), aiming improvements in strength and muscle volume (n=93, 90.3%), by using external load (n=82, 79.6%). The majority of the respondents (n=69, 67.0% attended a short course for BFRT, of which 55.1% (n=56) believed it was not evidence-based. No significant associations were found between the years of experience or attendance in a BFRT course with practices and perceptions of the surveyed physiotherapists (all p>0.05).

Conclusion: Current BFRT practices are largely not aligned with contemporary scientific evidence and recommendations.