Effect of blood flow restriction with low-intensity exercise on lower limb muscle strength and gait in people with multiple sclerosis: A randomized controlled trial

Abstract

Background: Up to 70 % of people with multiple sclerosis (PwMS) experience lower-extremity weakness, even in those with low disability. It has been correlated with reduced mobility and walking endurance.

Objective: Investigate the influence of blood flow restriction with low intensity resisted exercise on lower limb muscle strength and gait performance in PwMS.

Methods: Two groups were randomly selected from 41 relapsing-remitting PwMS of both sexes. Control group (CG): treated by a therapeutic low-intensity strengthening program for lower extremities. Study group (BFRG): treated with the same CG training program in addition to blood flow restriction (BFR) by inflated cuff in the proximal part of the thigh. The treatment was two sessions/week for six weeks. Isokinetic peak torque for knee extensors (KEPT), knee flexors (KFPT), hip flexors (HFPT), and hip extensors (HEPT) and spatiotemporal parameters of gait were measured by an isokinetic dynamometer, Biodex System, and 2D motion analysis, respectively, for both groups before and at the end of the treatment.

Results: Post-treatment, the two groups' results showed a significant increase in scores of KEPT, HFPT, and HEPT, with the study group showing more significant improvement (P < 0.05), while KFPT increased significantly only in BFRG (P < 0.05). The two groups showed non-significant differences (P > 0.05) in all spatiotemporal gait parameters.

Conclusion: Adding blood flow restriction to a low-intensity strengthening training program improves PwMS's lower limb muscular strength.

Keywords: Blood flow restriction exercises; Lower extremities; Multiple sclerosis; Muscle strength.