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Effectiveness of blood flow‐restricted slow walking on mobility in severe multiple sclerosis: A pilot randomized trial
Author(s) -
Lamberti Nicola,
Straudi Sofia,
Donadi Maria,
Tanaka Hirofumi,
Basaglia Nino,
Manfredini Fabio
Publication year - 2020
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.13764
Subject(s) - medicine , metronome , gait , physical therapy , physical medicine and rehabilitation , randomized controlled trial , preferred walking speed , balance (ability) , rehabilitation , quality of life (healthcare) , surgery , nursing , rhythm
Objective We tested the safety, feasibility, and effectiveness of blood flow restriction‐empowered low‐intensity interval walking exercise (BFR‐W) compared with conventional intensive overground walking (CON‐W) at improving gait speed and functional capacity in patients with multiple sclerosis (MS) and severe gait disabilities. Methods 24 patients (58 ± 5 years; 7 males) with progressive MS (Expanded Disability Status Scale 5.5 − 6.5) were randomized to receive 12 rehabilitation sessions over 6 weeks. The BFR‐W group (n = 12) performed interval walking (speed paced by a metronome that increased weekly) with BFR bands at the thighs. The CON‐W group (n = 12) received physiotherapist‐assisted overground walking therapy. The primary outcome was gait speed, measured by the timed 25‐foot walk test. Secondary outcomes included walking endurance, balance, strength, fatigue, and quality of life. The measurements were collected at baseline, at the end of training, and a 6‐week follow‐up. Results The two groups did not present any baseline difference. BFR‐W group safely walked without limitations due to sleeve compression, with lower increase in perceived exertion (RPE) ( P < .001) and heart rate ( P = .031) compared with the CON‐W. Gait speed improved significantly in both groups (BFR‐W + 13%; CON‐W + 5%) with greater increases in the BFR‐W group at end of the training ( P = .001) and at the follow‐up ( P = .041). Most of the secondary outcomes significantly improved in the two groups, without between‐group differences. Conclusions Slow interval walking with moderate BFR to the lower limbs was superior to overground walking in improving gait speed in patients with MS with a lower training load and a more durable clinical benefit.