Does exercise training combined with blood flow restriction improve muscle mass, lower extremity function, and walking capacity in hemiplegic patients? A randomized clinical trial

BACKGROUND: Blood flow restriction creates a state with increased motor function that permits treatment modalities to induce muscle hypertrophy. Blood flow-restricted exercise training (BFRET) may induce motor learning and boost the facilitatory effect of exercise training (ET). OBJECTIVE: This study investigated the effects of BFRET on post-stroke hemi paretic lower extremity function and walking capacity recovery. METHODOLOGY: This randomized clinical trial was conducted from September 2021 to October 2022 at the Department of Rehabilitation Medicine of the Second Affiliated Hospital of Chongqing Medical University in China. Participants were randomized 1:1 to BFRET or ET, each involving 30 minutes of training twice per day for 4 weeks. MAIN OUTCOMES MEASURES: The main outcomes were manual muscle testing (MMT) and Fugl-Meyer assessment scale-lower extremity (FMA-LE), the timed up and go test (TUGT), Outcomes were assessed by blinded raters after 4 weeks of training. RESULTS: 40 participants mean [SD] age 48.79[12.58] years, 30 males [75%], 20 were randomized to BFRET and 20 to ET. The mean (SD) time since stroke was 2.5 (1.3) years. The MMT scores showed greater strength by within-group comparisons and superior changes in hip flexion and plantar flexion in the BFRET group. CONCLUSIONS: BFRET is superior to ET alone in enhancing muscle mass and strength in the lower extremities. BFRET may improve the function of the lower extremities through physiological adaptations for muscle hypertrophy. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: ChiCTR2100050206.