Heterogeneous hypertrophy in low-load resistance training with blood flow restriction. A systematic review and meta-analysis

Low-load resistance training with blood flow restriction (BFR) is an effective training strategy for increasing strength and muscle size. Some studies have shown that muscle hypertrophy does not differ between low-load resistance training with BFR and high-load resistance training. However, these finding are from measurements taken in the medial part of the muscle. Therefore, they cannot be extrapolated to other muscle regions. When comparing muscle hypertrophy in different portion of the thigh (distal and proximal), Ellefsen et al. (2015) identified a difference between low-load with blood flow restriction versus high-load resistance training in the proximal portion of the muscle, favoring the last intervention, while there were no significant difference in the distal portion. Similarly, Centner et al. (2021) found a trend for difference between training models in the proximal region of the thigh, favoring the resistance training using higher loads. These results suggest the possibility of heterogeneous hypertrophy in low-load resistance training with BFR.