Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Department of Neurology, School of Medicine, University of Colorado, Aurora, Colorado, USA.
Phys Ther. 2024 Jan 1;104(1). doi: 10.1093/ptj/pzad135.
The objective of this study was to determine the feasibility of low-load resistance training with blood flow restriction (BFR) for people with advanced disability due to multiple sclerosis (MS).
In this prospective cohort study, 14 participants with MS (Expanded Disability Status Scale [EDSS] score = 6.0 to 7.0; mean age = 55.4 [SD = 6.2] years; 71% women) were asked to perform 3 lower extremity resistance exercises (leg press, calf press, and hip abduction) bilaterally twice weekly for 8 weeks using BFR. Feasibility criteria were as follows: enrollment of 20 participants, ≥80% retention and adherence, ≥90% satisfaction, and no serious adverse events related to the intervention. Other outcomes included knee extensor, ankle plantar flexor, and hip abductor muscle strength, 30-Second Sit-to-Stand Test, Berg Balance Scale, Timed 25-Foot Walk Test, 12-Item MS Walking Scale, Modified Fatigue Impact Scale, Patient-Specific Functional Scale, and daily step count.
Sixteen participants consented, and 14 completed the intervention, with 93% adherence overall. All participants were satisfied with the intervention. A minor hip muscle strain was the only intervention-related adverse event. There were muscle strength improvements on the more-involved (16%-28%) and less-involved (12%-19%) sides. There were also changes in the 30-Second Sit-to-Stand Test (1.9 repetitions; 95% CI = 1.0 to 2.8), Berg Balance Scale (5.3 points; 95% CI = 3.2 to 7.4), Timed 25-Foot Walk Test (-3.3 seconds; 95% CI = -7.9 to 1.3), Modified Fatigue Impact Scale (-8.8 points; 95% CI = -16.5 to -1.1), 12-Item MS Walking Scale (-3.6 points; 95% CI = -11.5 to 4.4), Patient-Specific Functional Scale (2.9 points; 95% CI = 1.9 to 3.8), and daily step count (333 steps; 95% CI = -191 to 857).
Low-load resistance training using BFR in people with MS and EDSS scores of 6.0 to 7.0 appears feasible, and subsequent investigation into its efficacy is warranted.
Although efficacy data are needed, combining BFR with low-load resistance training may be a viable alternative for people who have MS and who do not tolerate conventional moderate- to high-intensity training because of more severe symptoms, such as fatigue and weakness.
Low-load strength training with BFR was feasible in people who have advanced disability due to MS. Using BFR may provide an alternative for people with MS who do not tolerate higher intensity training due to more severe symptoms, such as fatigue and weakness.
本研究旨在确定使用血流限制（BFR）进行低负荷阻力训练对多发性硬化症（MS）导致的严重残疾患者的可行性。
在这项前瞻性队列研究中，14 名 MS 患者（扩展残疾状况量表[EDSS]评分=6.0 至 7.0；平均年龄=55.4[SD=6.2]岁；71%为女性）被要求每周两次使用 BFR 进行 3 项下肢阻力运动（腿推、小腿推和髋关节外展），共 8 周。可行性标准如下：纳入 20 名参与者、≥80%的保留和依从性、≥90%的满意度以及无与干预相关的严重不良事件。其他结果包括膝关节伸肌、踝关节跖屈肌和髋关节外展肌力量、30 秒坐站测试、伯格平衡量表、定时 25 英尺步行测试、12 项 MS 步行量表、改良疲劳影响量表、患者特定功能量表和日常步数。
16 名参与者同意参加，14 名参与者完成了干预，总体依从性为 93%。所有参与者对干预均满意。唯一与干预相关的不良事件是轻微的髋部肌肉拉伤。受累侧（16%-28%）和非受累侧（12%-19%）的肌肉力量均有所改善。30 秒坐站测试（1.9 次重复；95%CI=1.0 至 2.8）、伯格平衡量表（5.3 分；95%CI=3.2 至 7.4）、定时 25 英尺步行测试（-3.3 秒；95%CI=-7.9 至 1.3）、改良疲劳影响量表（-8.8 分；95%CI=-16.5 至-1.1）、12 项 MS 步行量表（-3.6 分；95%CI=-11.5 至 4.4）、患者特定功能量表（2.9 分；95%CI=1.9 至 3.8）和日常步数（333 步；95%CI=-191 至 857）也有所变化。
MS 患者 EDSS 评分为 6.0 至 7.0 时，使用 BFR 进行低负荷阻力训练似乎是可行的，因此有必要进一步研究其疗效。
尽管需要疗效数据，但结合 BFR 进行低负荷阻力训练可能是一种可行的选择，适用于因疲劳和虚弱等更严重症状而无法耐受常规中高强度训练的 MS 患者。
在 MS 导致严重残疾的患者中，使用 BFR 的低负荷力量训练是可行的。对于因疲劳和虚弱等更严重症状而无法耐受更高强度训练的 MS 患者，使用 BFR 可能是一种替代方法。
