Safety of blood flow restriction training in aesthetic gymnastics: a randomized controlled trial

Abstract

Long-term studies on the safety of blood flow restriction training in elite female athletes are virtually nonexistent, and the available data on adverse events are obtained primarily from short-term experiments (up to 12 weeks) using wide pneumatic cuffs. Therefore, it was necessary to systematically evaluate the safety of 180-day blood flow restriction training in elite gymnasts using narrow elastic bands. This randomized controlled trial included 20 female aesthetic gymnasts (18-25 years old, masters of sports and candidate masters of sports), randomized to an occlusion training group (n=10) and a control group (n=10). In the experimental group, elastic bands were applied to the upper (3 cm) and lower (5 cm) extremities with individually selected pressure based on Doppler ultrasound data (target arterial blood flow occlusion by 50%). Safety monitoring included a daily questionnaire on nine specific symptoms, visual inspection of the extremities before and after each workout, monitoring of blood pressure, heart rate, and oxygen saturation, and recording adverse events using the CONSORT 2025 form. Baseline risk was assessed using the Brandner scoring system. The overall risk score for all participants was 1, which corresponds to minimal risk and does not require medical approval. No serious adverse events were recorded over the 180 days of the experiment. At the end of the study, all 10 athletes in the experimental group rated the training comfort as the highest possible on a 5-point Likert scale. The incidence of any adverse events in the experimental group undergoing blood flow restriction training was 0%.