The Impact of Blood Flow Restriction and Resistance Training on Functional Outcomes and Fatigue in People with Multiple Sclerosis.

PURPOSE: Resistance training (RT) can improve functional outcomes among people with multiple sclerosis (PwMS) but is underutilized due to the use of heavy training loads. Low-load RT with blood flow restriction (RT + BFR) may provide an alternative. Therefore, the purpose of this study was to evaluate the effects of 12 wk of low-load RT + BFR and heavy-load RT on functional outcomes among PwMS.

METHODS

Seventeen PwMS (Expanded Disability Status Scale score, 0-6.5) completed 12 wk (2× a week) of heavy-load (65% of one-repetition maximum (1RM); n = 9) RT or low-load (30% of 1RM; n = 8) RT + BFR. Functional outcomes including gait speed (self-selected and fast 10-m Walk Test (10mWT)), walking endurance (6-Minute Walk Test (6MWT)), leg strength/transfers (Five Times Sit to Stand Test (5×STS), 30 Second Sit to Stand Test (30CST)), and fatigue (Modified Fatigue Impact Scale (MFIS)) were assessed every 4 wk.

RESULTS

Improvements in 10mWT (fast) occurred earlier for low-load RT + BFR (1.31 ± 0.24 to 1.79 ± 0.53 m·s -1 from weeks 0 to 8; P = 0.005) than heavy-load RT (1.19 ± 0.31 to 1.63 ± 0.58 m·s -1 from weeks 4 to 12; P = 0.005). MFIS was lower for low-load RT + BFR (16.25 ± 15.59 au) compared with heavy-load RT (32 ± 13.63 au) after 4 wk ( P = 0.042). 6MWT only improved in heavy-load RT from baseline to week 12 (309.1 ± 97.5 to 390.5 ± 100.4 m; P = 0.001), although baseline walking distance was higher in the low-load RT + BFR group (429.3 ± 42.1 m; P = 0.006). Improvements in 5×STS and 30CST were similar for both groups.

CONCLUSIONS

Low-load RT + BFR and heavy-load RT elicited comparable improvements among indices of strength, endurance, and walking speed with greater improvements in fatigue from low-load RT + BFR in PwMS. Thus, low-load RT + BFR may be a valuable modality to improve functional outcomes among PwMS in situations where heavy-load RT is intolerable.