Walking with blood flow restriction in Parkinson's disease: vascular, neurotrophic and functional outcomes: a randomized controlled trial (WALK-BFR-PD Trial).

BACKGROUND

Blood flow restriction (BFR) training induces beneficial adaptations at low exercise intensities. However, studies on its effects during walking exercise in individuals with Parkinson's disease (PD) remain limited.

METHODS

Twenty-four individuals with PD (Hoehn and Yahr stages 2-3) were randomly assigned to a walking exercise (WALK, n = 8), walking with BFR (WALK-BFR, n = 8), or control group (CON, n = 8). Both exercise groups performed supervised training twice weekly for 8 weeks; the WALK-BFR group was trained with BFR applied at 40-60% of the arterial occlusion pressure. The outcomes included vascular, neurotrophic, functional, and quality-of-life parameters. Exercise-related adverse events were recorded.

RESULTS

The WALK group did not show significant improvements in brain-derived neurotrophic factor (BDNF), flow-mediated dilation (FMD), brachial-ankle pulse wave velocity (baPWV), Five Times Sit-to-Stand Test, Timed Up and Go Test (TUGT), or 10-Meter Walk Test (10MWT) [all p > 0.05]. Although total Unified Parkinson's Disease Rating Scale (UPDRS) scores decreased in the WALK group, a similar reduction was observed in the CON group, with the only distinct improvement observed in UPDRS Part I. In contrast, WALK-BFR demonstrated significant improvements in BDNF and FMD (both p < 0.05), as well as functional performance (TUGT and 10MWT), quality of life (PDQ-8), and total UPDRS scores, with additional reductions in UPDRS Parts II-IV. However, baPWV did not significantly change in any group (p > 0.05). Both interventions were well tolerated, with a similar incidence of mild and transient lower-extremity muscle soreness in WALK and WALK-BFR groups.

CONCLUSION

WALK-BFR was associated with concurrent improvements in neurotrophic, vascular, and functional outcomes and quality of life in individuals with PD. Furthermore, the intervention was well tolerated and may represent a feasible rehabilitation strategy.