Effects of blood flow restriction therapy for lower limb dysfunction in stroke patients: a systematic review and...

To systematically evaluate the efficacy of blood flow restriction training (BFRT) for lower limb dysfunction in stroke patients.

Randomized controlled trials published up to October 2025 were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library. The control group received conventional rehabilitation, while the intervention group received conventional rehabilitation combined with BFRT.

Eleven studies involving 522 patients were included. The intervention group achieved significantly higher Berg Balance Scale scores [MD = 4.52, 95% CI (0.78, 8.26), p = 0.02] and longer 6-min walk test distances [MD = 9.73, 95% CI (7.26, 12.21), p < 0.00001]. Subgroup analysis showed that when the intervention duration exceeded 4 weeks, the intervention group achieved higher lower-extremity Fugl-Meyer Assessment scores [MD = 4.38, 95% CI (2.00, 6.77), p = 0.0003] and Modified Barthel Index scores [MD = 10.50, 95% CI (6.32, 14.68), p < 0.00001] than the control group. Among patients in the subacute phase, the intervention group also demonstrated higher lower-extremity Fugl-Meyer Assessment scores [MD = 2.63, 95% CI (0.42, 4.83), p = 0.02].

BFRT improves balance and walking endurance in stroke patients. When delivered for more than 4 weeks, it yields additional benefits in lower limb motor function and activities of daily living, with more pronounced motor improvements observed in the subacute phase. Owing to limitations in sample size, treatment protocol heterogeneity, and methodological quality, these findings require confirmation through large-scale, high-quality studies.