Effects of combining blood flow restriction with whole-body vibration training on muscle strength and hypertrophy: A systematic review and meta-analysis
Longguo Zhang, Shijie Fan, Yuvathi Arunkumar, Sehrish Noor, Zhaodong Bi, Yongle Guo, Weimin PanBackground
Whole-body vibration training (WBVT) stimulates muscles via mechanical oscillations to induce involuntary contractions, offering an alternative for those unable to engage in conventional voluntary resistance exercise. Since blood flow restriction (BFR) promotes adaptations through metabolic stress, combining it with WBVT may potentiate muscular adaptations.
Objectives
To determine whether muscle strength and hypertrophy adaptations from WBVT could be enhanced when performed under BFR conditions.
Methods
We searched nine databases (PubMed, Embase, Scopus, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and CBM) from inception through 25 May 2026. Randomized controlled trials (RCTs) comparing WBVT-BFR with WBVT alone in healthy participants were included. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Meta-analyses were conducted using standardized mean differences (SMD) with 95% confidence intervals (CIs), and overall certainty of evidence was evaluated using GRADE.
Results
Five RCTs (total n = 153; WBVT-BFR: n = 75; WBVT: n = 78) were included. Pooled analysis demonstrated a significant effect favoring WBVT-BFR for muscle strength (SMD=0.32; 95% CI, 0.03 to 0.61; p = 0.03) with low heterogeneity (I 2 =14%; p = 0.32). For muscle hypertrophy, the pooled effect reached marginal significance (SMD=0.41; 95% CI, −0.01 to 0.83; p = 0.05), with no significant heterogeneity (I 2 =0%; p = 0.60). However, leave-one-out sensitivity analyses revealed that findings for both outcomes were not robust and were heavily influenced by individual studies. Consequently, the overall certainty of evidence for both outcomes was rated as very low.
Conclusions
The current evidence regarding the superiority of WBVT-BFR over WBVT alone for enhancing both muscle strength and hypertrophy remains inconclusive. Although initial analyses showed a small advantage for strength and a marginal effect for hypertrophy, sensitivity testing revealed both findings were fragile. Consequently, these results must be interpreted with strict caution due to the high risk of bias and very low certainty of the available evidence.