Effects of Blood Flow Restriction Exercise on Muscle Oxygenation and Microvascular Function in Healthy Individuals: A...

Blood flow restriction (BFR) training involves partial occlusion of limb blood flow during exercise, and it is known to promote gains in skeletal muscle strength and hypertrophy. However, its impact on muscle oxygenation and microvascular function remains unclear, as recent studies and reviews have mainly focused on macrovascular acute and chronic adaptations. This review aimed to examine the effects of BFR exercise on muscle oxygenation and microvascular function in healthy individuals. Research for this narrative review was conducted on PubMed/MEDLINE in January 2026. Randomized and non-randomized trials on healthy adults assessing the effects of acute or long-term BFR exercise on muscle oxygenation and microvascular function via near-infrared spectroscopy (NIRS), compared to non-BFR exercise, were included. Sixteen studies met the inclusion criteria. Acute BFR exercise was associated with significantly elevated skeletal muscle deoxygenated hemoglobin (HHb) and total hemoglobin (tHb) responses, while O₂Hb and tissue saturation index (TSI) decreased to a greater extent compared to non-BFR exercise. Evidence on the effects of chronic BFR training on muscle oxygenation is limited but suggests a potential improvement in muscle oxygen extraction, as reflected by higher HHb levels. The few studies that examined BFR effects on microvascular function/reactive hyperemia report a greater TSI reperfusion slope during vascular occlusion tests following a BFR resistance exercise bout. BFR exercise appears to elicit greater muscle deoxygenation responses than traditional free-flow training, suggesting a stronger stimulus for chronic muscular adaptations. However, evidence regarding microvascular function/reactivity is very limited, and further research is warranted to determine the acute and chronic effects of BFR exercise.