血流限制性训练对脑卒中后肌肉力量康复的 研究进展
Research Progress on Blood Flow Restriction Training for Muscle Strength Rehabilitation after Stroke
DOI: 10.12677/acm.2026.163951, PDF,    科研立项经费支持
作者: 方除维, 江 海, 杨承卓*：重庆医科大学附属康复医院康复医学科，重庆
关键词: 血流限制性训练；脑卒中；肌肉力量；康复训练；Blood Flow Restriction Training； Stroke； Muscle Strength； Rehabilitation Training
摘要: 绝大多数脑卒中患者发病后都会出现明显的肌肉力量下降，导致肢体功能障碍，严重影响生活治疗。血流限制性训练能明显改善肢体的肌肉力量，研究表明其结合低负荷训练能够达到与大负荷训练相似的效果，此外血流限制性训练安全性较高，鲜有报道训练后出现不良事件，从而被广泛运用在肢体力量训练中，其中也包括脑卒中患者肌力康复训练。本文综述了血流限制训练的原理、作用机制，分析其在脑卒中患者临床应用和进展，简述了相关的训练方案和训练时安全注意事项，以期为血流限制性训练在脑卒中患者中的个性化训练及具体方案的优化提供新思路。
Abstract: The majority of stroke patients experience significant muscle weakness following onset, leading to limb dysfunction and severely impacting daily activities and treatment. Blood flow restriction training can significantly improve limb muscle strength. Research indicates that combining it with low-load training can achieve effects similar to those of high-load training. Additionally, blood flow restriction training is highly safe, with few reported adverse events following training, making it widely applied in limb strength training, including muscle strength rehabilitation training for stroke patients. This article reviews the principles and mechanisms of blood flow restriction training, analyzes its clinical application and progress in stroke patients, and briefly outlines related training protocols and safety precautions during training. The aim is to provide new insights for personalized training and the optimization of specific protocols for blood flow restriction training in stroke patients.
文章引用：方除维, 江海, 杨承卓. 血流限制性训练对脑卒中后肌肉力量康复的 研究进展[J]. 临床医学进展, 2026, 16(3): 1665-1673. https://doi.org/10.12677/acm.2026.163951

参考文献

[1] Feigin, V.L., Brainin, M., Norrving, B., Martins, S.O., Pandian, J., Lindsay, P., et al. (2025) World Stroke Organization: Global Stroke Fact Sheet 2025. International Journal of Stroke, 20, 132-144. [Google Scholar] [CrossRef] [PubMed]
[2] 《中国脑卒中防治报告2021》概要[J]. 中国脑血管病杂志, 2023, 20(11): 783-793.
[3] Irisawa, H. and Mizushima, T. (2022) Assessment of Changes in Muscle Mass, Strength, and Quality and Activities of Daily Living in Elderly Stroke Patients. International Journal of Rehabilitation Research, 45, 161-167. [Google Scholar] [CrossRef] [PubMed]
[4] Gray, V., Rice, C.L. and Garland, S.J. (2012) Factors That Influence Muscle Weakness Following Stroke and Their Clinical Implications: A Critical Review. Physiotherapy Canada, 64, 415-426. [Google Scholar] [CrossRef] [PubMed]
[5] Hughes, L., Paton, B., Rosenblatt, B., Gissane, C. and Patterson, S.D. (2017) Blood Flow Restriction Training in Clinical Musculoskeletal Rehabilitation: A Systematic Review and Meta-Analysis. British Journal of Sports Medicine, 51, 1003-1011. [Google Scholar] [CrossRef] [PubMed]
[6] Korkmaz, E., Dönmez, G., Uzuner, K., Babayeva, N., Torgutalp, Ş.Ş. and Özçakar, L. (2020) Effects of Blood Flow Restriction Training on Muscle Strength and Architecture. Journal of Strength & Conditioning Research, 36, 1396-1403. [Google Scholar] [CrossRef] [PubMed]
[7] de Lemos Muller, C.H., Farinha, J.B., Leal-Menezes, R. and Ramis, T.R. (2024) Aerobic Training with Blood Flow Restriction on Muscle Hypertrophy and Strength: Systematic Review and Meta-Analysis. Journal of Strength & Conditioning Research, 38, 1341-1349. [Google Scholar] [CrossRef] [PubMed]
[8] Cognetti, D.J., Sheean, A.J. and Owens, J.G. (2022) Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation. Arthroscopy, Sports Medicine, and Rehabilitation, 4, e71-e76. [Google Scholar] [CrossRef] [PubMed]
[9] Sato, Y. (2005) The History and Future of KAATSU Training. International Journal of KAATSU Training Research, 1, 1-5. [Google Scholar] [CrossRef] 
[10] Goto, K., Ishii, N., Kizuka, T., et al. (2005) The Impact of Metabolic Stress on Hormonal Responses and Muscular Adaptations. Medicine & Science in Sports & Exercise, 37, 955-963.
[11] Suga, T., Okita, K., Morita, N., Yokota, T., Hirabayashi, K., Horiuchi, M., et al. (2009) Intramuscular Metabolism during Low-Intensity Resistance Exercise with Blood Flow Restriction. Journal of Applied Physiology, 106, 1119-1124. [Google Scholar] [CrossRef] [PubMed]
[12] Takarada, Y., Nakamura, Y., Aruga, S., Onda, T., Miyazaki, S. and Ishii, N. (2000) Rapid Increase in Plasma Growth Hormone after Low-Intensity Resistance Exercise with Vascular Occlusion. Journal of Applied Physiology, 88, 61-65. [Google Scholar] [CrossRef] [PubMed]
[13] Schoenfeld, B.J. (2010) The Mechanisms of Muscle Hypertrophy and Their Application to Resistance Training. Journal of Strength and Conditioning Research, 24, 2857-2872. [Google Scholar] [CrossRef] [PubMed]
[14] Reeves, G.V., Kraemer, R.R., Hollander, D.B., Clavier, J., Thomas, C., Francois, M., et al. (2006) Comparison of Hormone Responses Following Light Resistance Exercise with Partial Vascular Occlusion and Moderately Difficult Resistance Exercise without Occlusion. Journal of Applied Physiology, 101, 1616-1622. [Google Scholar] [CrossRef] [PubMed]
[15] Fry, C.S., Glynn, E.L., Drummond, M.J., Timmerman, K.L., Fujita, S., Abe, T., et al. (2010) Blood Flow Restriction Exercise Stimulates mTORC1 Signaling and Muscle Protein Synthesis in Older Men. Journal of Applied Physiology, 108, 1199-1209. [Google Scholar] [CrossRef] [PubMed]
[16] Fujita, S., Abe, T., Drummond, M.J., Cadenas, J.G., Dreyer, H.C., Sato, Y., et al. (2007) Blood Flow Restriction during Low-Intensity Resistance Exercise Increases S6K1 Phosphorylation and Muscle Protein Synthesis. Journal of Applied Physiology, 103, 903-910. [Google Scholar] [CrossRef] [PubMed]
[17] Laurentino, G.C., Ugrinowitsch, C., Roschel, H., Aoki, M.S., Soares, A.G., Neves, M., et al. (2012) Strength Training with Blood Flow Restriction Diminishes Myostatin Gene Expression. Medicine & Science in Sports & Exercise, 44, 406-412. [Google Scholar] [CrossRef] [PubMed]
[18] Hwang, P.S. and Willoughby, D.S. (2019) Mechanisms behind Blood Flow-Restricted Training and Its Effect toward Muscle Growth. Journal of Strength and Conditioning Research, 33, S167-S179. [Google Scholar] [CrossRef] [PubMed]
[19] Wernbom, M., Apro, W., Paulsen, G., Nilsen, T.S., Blomstrand, E. and Raastad, T. (2013) Acute Low-Load Resistance Exercise with and without Blood Flow Restriction Increased Protein Signalling and Number of Satellite Cells in Human Skeletal Muscle. European Journal of Applied Physiology, 113, 2953-2965. [Google Scholar] [CrossRef] [PubMed]
[20] Takarada, Y., Sato, Y. and Ishii, N. (2002) Effects of Resistance Exercise Combined with Vascular Occlusion on Muscle Function in Athletes. European Journal of Applied Physiology, 86, 308-314. [Google Scholar] [CrossRef] [PubMed]
[21] Yasuda, T., Brechue, W.F., Fujita, T., Shirakawa, J., Sato, Y. and Abe, T. (2009) Muscle Activation during Low-Intensity Muscle Contractions with Restricted Blood Flow. Journal of Sports Sciences, 27, 479-489. [Google Scholar] [CrossRef] [PubMed]
[22] Bowman, E.N., Elshaar, R., Milligan, H., Jue, G., Mohr, K., Brown, P., et al. (2020) Upper-Extremity Blood Flow Restriction: The Proximal, Distal, and Contralateral Effects—A Randomized Controlled Trial. Journal of Shoulder and Elbow Surgery, 29, 1267-1274. [Google Scholar] [CrossRef] [PubMed]
[23] Dankel, S.J., Jessee, M.B., Abe, T. and Loenneke, J.P. (2015) The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure. Sports Medicine, 46, 23-33. [Google Scholar] [CrossRef] [PubMed]
[24] Baar, K. and Esser, K. (1999) Phosphorylation of p70(S6k) Correlates with Increased Skeletal Muscle Mass Following Resistance Exercise. American Journal of Physiology-Cell Physiology, 276, C120-C127. [Google Scholar] [CrossRef] [PubMed]
[25] Bodine, S.C., Stitt, T.N., Gonzalez, M., Kline, W.O., Stover, G.L., Bauerlein, R., et al. (2001) Akt/mTOR Pathway Is a Crucial Regulator of Skeletal Muscle Hypertrophy and Can Prevent Muscle Atrophy in Vivo. Nature Cell Biology, 3, 1014-1019. [Google Scholar] [CrossRef] [PubMed]
[26] Reynolds, T.H., Bodine, S.C. and Lawrence, J.C. (2002) Control of Ser2448 Phosphorylation in the Mammalian Target of Rapamycin by Insulin and Skeletal Muscle Load. Journal of Biological Chemistry, 277, 17657-17662. [Google Scholar] [CrossRef] [PubMed]
[27] Kawada, S. and Ishii, N. (2005) Skeletal Muscle Hypertrophy after Chronic Restriction of Venous Blood Flow in Rats. Medicine & Science in Sports & Exercise, 37, 1144-1150. [Google Scholar] [CrossRef] [PubMed]
[28] Drummond, M.J., Fujita, S., Takashi, A., Dreyer, H.C., Volpi, E. and Rasmussen, B.B. (2008) Human Muscle Gene Expression Following Resistance Exercise and Blood Flow Restriction. Medicine & Science in Sports & Exercise, 40, 691-698. [Google Scholar] [CrossRef] [PubMed]
[29] Brandner, C.R., Warmington, S.A. and Kidgell, D.J. (2015) Corticomotor Excitability Is Increased Following an Acute Bout of Blood Flow Restriction Resistance Exercise. Frontiers in Human Neuroscience, 9, Article No. 652. [Google Scholar] [CrossRef] [PubMed]
[30] Næss-Schmidt, E.T., Morthorst, M., Pedersen, A.R., Nielsen, J.F. and Stubbs, P.W. (2017) Corticospinal Excitability Changes Following Blood Flow Restriction Training of the Tibialis Anterior: A Preliminary Study. Heliyon, 3, e00217. [Google Scholar] [CrossRef] [PubMed]
[31] Colomer-Poveda, D., Romero-Arenas, S., Vera-Ibáñez, A., Viñuela-García, M. and Márquez, G. (2017) Effects of 4 Weeks of Low-Load Unilateral Resistance Training, with and without Blood Flow Restriction, on Strength, Thickness, V Wave, and H Reflex of the Soleus Muscle in Men. European Journal of Applied Physiology, 117, 1339-1347. [Google Scholar] [CrossRef] [PubMed]
[32] Copithorne, D.B., Rice, C.L. and McNeil, C.J. (2020) Effect of Blood Flow Occlusion on Corticospinal Excitability during Sustained Low-Intensity Isometric Elbow Flexion. Journal of Neurophysiology, 123, 1113-1119. [Google Scholar] [CrossRef] [PubMed]
[33] Frechette, M.L., Cook, S.B., Scott, B.R., Tan, J. and Vallence, A. (2025) Post‐Exercise Neural Plasticity Is Augmented by Adding Blood Flow Restriction during Low Work Rate Arm Cycling. Experimental Physiology, 110, 877-887. [Google Scholar] [CrossRef] [PubMed]
[34] 陈雪梅, 余广兰. 血流限制联合低强度抗阻运动在脑梗死合并肌少症老年患者的应用研究[J]. 神经损伤与功能重建, 2023, 18(1): 23-27.
[35] 龚健婷, 吕仁华, 李青, 等. 血流限制性训练联合头针治疗中风患者平衡功能的临床研究[J]. 湖南中医药大学学报, 2025, 45(3): 480-485.
[36] Hyngstrom, A.S., Murphy, S.A., Nguyen, J., Schmit, B.D., Negro, F., Gutterman, D.D., et al. (2018) Ischemic Conditioning Increases Strength and Volitional Activation of Paretic Muscle in Chronic Stroke: A Pilot Study. Journal of Applied Physiology, 124, 1140-1147. [Google Scholar] [CrossRef] [PubMed]
[37] Li, Y., Liang, K., Zhang, L., Hu, Y., Ge, Y. and Zhao, J. (2018) Upper Limb Ischemic Postconditioning as Adjunct Therapy in Acute Stroke Patients: A Randomized Pilot. Journal of Stroke and Cerebrovascular Diseases, 27, 3328-3335. [Google Scholar] [CrossRef] [PubMed]
[38] Ohta, H., Kurosawa, H., Ikeda, H., Iwase, Y., Satou, N. and Nakamura, S. (2003) Low-Load Resistance Muscular Training with Moderate Restriction of Blood Flow after Anterior Cruciate Ligament Reconstruction. Acta Orthopaedica Scandinavica, 74, 62-68. [Google Scholar] [CrossRef] 
[39] Bryk, F.F., dos Reis, A.C., Fingerhut, D., Araujo, T., Schutzer, M., Cury, R.d.P.L., et al. (2016) Exercises with Partial Vascular Occlusion in Patients with Knee Osteoarthritis: A Randomized Clinical Trial. Knee Surgery, Sports Traumatology, Arthroscopy, 24, 1580-1586. [Google Scholar] [CrossRef] [PubMed]
[40] Centner, C., Wiegel, P., Gollhofer, A. and König, D. (2018) Effects of Blood Flow Restriction Training on Muscular Strength and Hypertrophy in Older Individuals: A Systematic Review and Meta-Analysis. Sports Medicine, 49, 95-108. [Google Scholar] [CrossRef] [PubMed]
[41] Coe, R. (2002) It’s the Effect Size, Stupid: What Effect Size Is and Why It Is Important.
[42] Ozaki, H., Miyachi, M., Nakajima, T. and Abe, T. (2010) Effects of 10 Weeks Walk Training with Leg Blood Flow Reduction on Carotid Arterial Compliance and Muscle Size in the Elderly Adults. Angiology, 62, 81-86. [Google Scholar] [CrossRef] [PubMed]
[43] Libardi, C., Chacon-Mikahil, M., Cavaglieri, C., Tricoli, V., Roschel, H., Vechin, F., et al. (2015) Effect of Concurrent Training with Blood Flow Restriction in the Elderly. International Journal of Sports Medicine, 36, 395-399. [Google Scholar] [CrossRef] [PubMed]
[44] Wernbom, M., Augustsson, J. and Raastad, T. (2008) Ischemic Strength Training: A Low‐Load Alternative to Heavy Resistance Exercise? Scandinavian Journal of Medicine & Science in Sports, 18, 401-416. [Google Scholar] [CrossRef] [PubMed]
[45] Formiga, M.F., Fay, R., Hutchinson, S., Locandro, N., Ceballos, A., Lesh, A., et al. (2020) Effect of Aerobic Exercise Training with and without Blood Flow Restriction on Aerobic Capacity in Healthy Young Adults: A Systematic Review with Meta-Analysis. International Journal of Sports Physical Therapy, 15, 175-187. [Google Scholar] [CrossRef] 
[46] Abe, T., Kearns, C.F. and Sato, Y. (2006) Muscle Size and Strength Are Increased Following Walk Training with Restricted Venous Blood Flow from the Leg Muscle, Kaatsu-Walk Training. Journal of Applied Physiology, 100, 1460-1466. [Google Scholar] [CrossRef] [PubMed]
[47] Patterson, S.D., Hughes, L., Warmington, S., Burr, J., Scott, B.R., Owens, J., et al. (2019) Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Frontiers in Physiology, 10, Article No. 533. [Google Scholar] [CrossRef] [PubMed]
[48] Park, S., Kim, J.K., Choi, H.M., Kim, H.G., Beekley, M.D. and Nho, H. (2010) Increase in Maximal Oxygen Uptake Following 2-Week Walk Training with Blood Flow Occlusion in Athletes. European Journal of Applied Physiology, 109, 591-600. [Google Scholar] [CrossRef] [PubMed]
[49] Yu, L., Xue, P., Qian, L., Feng, W. and Yao, Q. (2025) Blood Flow Restriction Training Combined with Muscle Energy Technology for Upper Limb Functional Recovery in Poststroke Spasticity: A Randomised Controlled Trial Protocol at a Tertiary Hospital in Jiaxing, China. BMJ Open, 15, e092848. [Google Scholar] [CrossRef] 
[50] Loenneke, J.P., Allen, K.M., Mouser, J.G., Thiebaud, R.S., Kim, D., Abe, T., et al. (2014) Blood Flow Restriction in the Upper and Lower Limbs Is Predicted by Limb Circumference and Systolic Blood Pressure. European Journal of Applied Physiology, 115, 397-405. [Google Scholar] [CrossRef] [PubMed]
[51] Jessee, M.B., Buckner, S.L., Dankel, S.J., Counts, B.R., Abe, T. and Loenneke, J.P. (2016) The Influence of Cuff Width, Sex, and Race on Arterial Occlusion: Implications for Blood Flow Restriction Research. Sports Medicine, 46, 913-921. [Google Scholar] [CrossRef] [PubMed]
[52] Jønsson, A.B., Krogh, S., Laursen, H.S., Aagaard, P., Kasch, H. and Nielsen, J.F. (2024) Safety and Efficacy of Blood Flow Restriction Exercise in Individuals with Neurological Disorders: A Systematic Review. Scandinavian Journal of Medicine & Science in Sports, 34, e14561. [Google Scholar] [CrossRef] [PubMed]
[53] Waclawovsky, G. and Lehnen, A.M. (2015) Hemodynamics of Aerobic and Resistance Blood Flow Restriction Exercise in Young and Older Adults. European Journal of Applied Physiology, 116, 859-860. [Google Scholar] [CrossRef] [PubMed]
[54] Manini, T.M. and Clark, B.C. (2009) Blood Flow Restricted Exercise and Skeletal Muscle Health. Exercise and Sport Sciences Reviews, 37, 78-85. [Google Scholar] [CrossRef] [PubMed]
[55] Nakajima, T., Kurano, M., Iida, H., Takano, H., Oonuma, H., Morita, T., et al. (2006) Use and Safety of KAATSU Training: Results of a National Survey. International Journal of KAATSU Training Research, 2, 5-13. [Google Scholar] [CrossRef] 
[56] Iversen, E. and Røstad, V. (2010) Low-Load Ischemic Exercise-Induced Rhabdomyolysis. Clinical Journal of Sport Medicine, 20, 218-219. [Google Scholar] [CrossRef] [PubMed]
[57] Tabata, S., Suzuki, Y., Azuma, K. and Matsumoto, H. (2016) Rhabdomyolysis after Performing Blood Flow Restriction Training: A Case Report. Journal of Strength and Conditioning Research, 30, 2064-2068. [Google Scholar] [CrossRef] [PubMed]
[58] Nascimento, D.d.C., Petriz, B., da Cunha Oliveira, S., Leite Vieira, D.C., Schwerz Funghetto, S., Silva, A.O., et al. (2019) effects of Blood Flow Restriction Exercise on Hemostasis: A Systematic Review of Randomized and Non-Randomized Trials. International Journal of General Medicine, 12, 91-100. [Google Scholar] [CrossRef] [PubMed]
[59] Stavres, J., Singer, T.J., Brochetti, A., Kilbane, M.J., Brose, S.W. and McDaniel, J. (2018) The Feasibility of Blood Flow Restriction Exercise in Patients with Incomplete Spinal Cord Injury. PM&R, 10, 1368-1379. [Google Scholar] [CrossRef] [PubMed]

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