Cummings Mark, Madhavan Sangeetha
Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
Exp Brain Res. 2024 Dec;242(12):2665-2676. doi: 10.1007/s00221-024-06941-5. Epub 2024 Oct 5.
Ischemic Conditioning (IC) is a procedure involving brief periods of occlusion followed by reperfusion in stationary limbs. Blood Flow Restriction with Exercise (BFR-E) is a technique comprising blood flow restriction during aerobic or resistance exercise. Both IC and BFR-E are Blood Flow Modulation (BFM) strategies that have shown promise across various health domains and are clinically relevant for stroke rehabilitation. Despite their potential benefits, our knowledge on the application and efficacy of either intervention in stroke is limited. This scoping review aims to synthesize the existing literature on the impact of IC and BFR-E on motor and neurophysiological outcomes in individuals post-stroke. Evidence from five studies displayed enhancements in paretic leg strength, gait speed, and paretic leg fatiguability after IC. Additionally, BFR-E led to improvements in clinical performance, gait parameters, and serum lactate levels. While trends toward motor function improvement were observed post-intervention, statistically significant differences were limited. Neurophysiological changes showed inconclusive results. Our review suggests that IC and BFR-E are promising clinical approaches in stroke, however high-quality studies focusing on neurophysiological mechanisms are required to establish the efficacy and underlying mechanisms of both in stroke. Recommendations regarding future directions and clinical utility are provided.
缺血预处理（IC）是一种在静止肢体中进行短暂闭塞随后再灌注的程序。运动性血流限制（BFR-E）是一种在有氧或抗阻运动期间进行血流限制的技术。IC和BFR-E都是血流调节（BFM）策略，已在各个健康领域显示出前景，并且在中风康复中具有临床相关性。尽管它们具有潜在益处，但我们对这两种干预措施在中风中的应用和疗效的了解有限。本范围综述旨在综合现有文献，探讨IC和BFR-E对中风后个体运动和神经生理结果的影响。五项研究的证据显示，IC后患侧腿部力量、步态速度和患侧腿部疲劳性有所增强。此外，BFR-E导致临床性能、步态参数和血清乳酸水平得到改善。虽然干预后观察到运动功能有改善趋势，但统计学上的显著差异有限。神经生理变化显示结果不明确。我们的综述表明，IC和BFR-E在中风治疗中是有前景的临床方法，然而需要高质量的研究来关注神经生理机制，以确定两者在中风中的疗效和潜在机制。本文还提供了关于未来方向和临床应用的建议。
