The Effects of Blood Flow Restriction (BFR) Training on Quadriceps Strength Following ACL Reconstruction: A Systematic Review

Abstract

Objective: To review the relevant literature examining the effects of Blood Flow Restriction (BFR) on quadriceps strength in patients after ACL reconstruction surgery and the overall rehabilitation process. Methods: Literature was collected through Google Scholar, Pub Med and CINAHL in January and February 2026 to assess the impacts of BFR with standard rehabilitation protocols and effects on quadriceps strength in post-operative ACL reconstruction patients. Nine studies met the inclusion criteria. Results: Most of the studies found that BFR increased the cross-sectional thickness of the quadriceps, improved both quadriceps strength and knee flexion and extension. However, some studies found no significant results. Variability in study design and patient age population limited comparability. Conclusions: BFR may have a positive impact on patients after ACL reconstruction experiencing quadricep muscular atrophy, but evidence remains inconsistent. To be proven more effective, studies should include the use of BFR among different patient populations.