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<p>Traditional resistance training is often prescribed to stimulate skeletal muscle hypertrophy in adults, however voluntary mechanical movement is not possible for all individuals. The combination of blood flow restriction and neuromuscular electrical stimulation (C-BFR-NMES) has recently been shown to be a passive intervention to promote skeletal muscle hypertrophy in adults. However, due to various protocols being used in the literature, varying amounts of skeletal muscle hypertrophy have been reported. The aim of this systematic review and meta-analysis was to quantitatively investigate the effectiveness of C-BFR-NMES compared to BFR or NMES alone, or no intervention to induce skeletal muscle mass in adults. The secondary aims were to compare muscle hypertrophy outcomes when different measurement devices are used following C-BFR-NMES, and to investigate the C-BFR-NMES protocols used to induce skeletal muscle hypertrophy in adults. A PRISMA-compliant systematic review and meta-analysis was conducted. PubMed, MEDLINE, Web of Science, Scopus and CINAHL were searched from inception to 28 February 2025 using the following inclusion criteria: (1) untrained healthy adults (between the age of 18–64 years), (2) study design allowed comparison between C-BFR-NMES and CONTROL (BFR or NMES alone, or no intervention), (3) lower limb skeletal muscle hypertrophy was assessed pre/post intervention, (4) interventions included study periods ≥ 14 days, and (5) manuscripts written in English. Standardised mean differences (SMDs) were calculated for each comparison, and a multilevel random-effects model was fitted. A total of 615 articles were screened, three studies with a total population of <i>N</i> = 37 were included, and seven meta-analyses were conducted. C-BFR-NMES induced non significant increases in skeletal muscle hypertrophy compared to CONTROL (<i>p</i> = 0.176), with a medium pooled effect size of d = 0.64 (95% CI -0.37 to 1.65) in favour of C-BFR-NMES. A pooled analysis of current data suggests the C-BFR-NMES may produce a medium positive effect on skeletal muscle hypertrophy in lower body musculature compared with control conditions; however, this effect was not statistically significant. Further larger randomised controlled trials are needed to determine the effectiveness of C-BFR-NMES, and applicability to upper body musculature, as well as different cohorts such as adolescent and older populations.</p>

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Effects of combined blood flow restriction and neuromuscular electrical stimulation on skeletal muscle hypertrophy in adults: a systematic review and meta analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月19日

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  • Jon K. Mangahas,
  • Lance C. Dalleck,
  • Claire Drummond,
  • Adel Ghorbani,
  • Kym Williams,
  • Joyce S. Ramos

摘要

Traditional resistance training is often prescribed to stimulate skeletal muscle hypertrophy in adults, however voluntary mechanical movement is not possible for all individuals. The combination of blood flow restriction and neuromuscular electrical stimulation (C-BFR-NMES) has recently been shown to be a passive intervention to promote skeletal muscle hypertrophy in adults. However, due to various protocols being used in the literature, varying amounts of skeletal muscle hypertrophy have been reported. The aim of this systematic review and meta-analysis was to quantitatively investigate the effectiveness of C-BFR-NMES compared to BFR or NMES alone, or no intervention to induce skeletal muscle mass in adults. The secondary aims were to compare muscle hypertrophy outcomes when different measurement devices are used following C-BFR-NMES, and to investigate the C-BFR-NMES protocols used to induce skeletal muscle hypertrophy in adults. A PRISMA-compliant systematic review and meta-analysis was conducted. PubMed, MEDLINE, Web of Science, Scopus and CINAHL were searched from inception to 28 February 2025 using the following inclusion criteria: (1) untrained healthy adults (between the age of 18–64 years), (2) study design allowed comparison between C-BFR-NMES and CONTROL (BFR or NMES alone, or no intervention), (3) lower limb skeletal muscle hypertrophy was assessed pre/post intervention, (4) interventions included study periods ≥ 14 days, and (5) manuscripts written in English. Standardised mean differences (SMDs) were calculated for each comparison, and a multilevel random-effects model was fitted. A total of 615 articles were screened, three studies with a total population of N = 37 were included, and seven meta-analyses were conducted. C-BFR-NMES induced non significant increases in skeletal muscle hypertrophy compared to CONTROL (p = 0.176), with a medium pooled effect size of d = 0.64 (95% CI -0.37 to 1.65) in favour of C-BFR-NMES. A pooled analysis of current data suggests the C-BFR-NMES may produce a medium positive effect on skeletal muscle hypertrophy in lower body musculature compared with control conditions; however, this effect was not statistically significant. Further larger randomised controlled trials are needed to determine the effectiveness of C-BFR-NMES, and applicability to upper body musculature, as well as different cohorts such as adolescent and older populations.