Efficacy and Safety of Low-Intensity Blood Flow Restriction Training in the Management of Diabetic Neuropathy: A Literature Review

: Background: Diabetic neuropathy (DN) is a prevalent complication of diabetes mellitus leading to significant sensory and motor deficits. Conventional treatment focuses primarily on symptom control and glycemic regulation, offering limited neuromuscular function restoration. Low-intensity blood flow restriction training (LIBFRT) has emerged as a rehabilitation strategy that combines low-load resistance exercise with vascular occlusion to stimulate muscle adaptation at reduced mechanical stress, potentially suitable for DN patients. Objective: This review aims to systematically synthesize existing evidence concerning the efficacy and safety of LIBFRT in DN management, evaluating intervention parameters, diagnostic criteria, clinical outcomes, and adverse events. Methods: A comprehensive literature search identified 12 interventional studies (2010–2025) involving patients with clinically and neurophysiologically confirmed DN undergoing LIBFRT. Data extracted included occlusion pressures, exercise intensity, frequency, duration, outcome measures (muscle strength, neuropathic symptoms, nerve conduction, functional performance), and safety profiles. Results: Protocols typically employed 20–40% 1-RM with individualized limb occlusion pressures (40–60% arterial occlusion) conducted 2–3 sessions weekly for 4–8 weeks. Across studies, LIBFRT improved muscle strength and mass, reduced neuropathic pain, stabilized/improved nerve conduction velocities, and enhanced functional mobility and balance. Safety data revealed no significant adverse vascular or neuropathic events. Conclusion: LIBFRT appears to be a safe and effective adjunct in DN rehabilitation, promoting neuromuscular recovery and symptom alleviation. It merits incorporation into multidisciplinary care, but further large-scale RCTs with longer follow-up are warranted to refine protocols and confirm sustained benefits.