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 resistance training with blood-flow restriction (RT + BFR) may provide an alternative. Therefore, the purpose of this study was to evaluate the effects of 12 weeks of low-load RT + BFR and heavy-load RT on functional outcomes among PwMS. METHODS Seventeen PwMS (EDSS 0 to 6.5) completed 12 weeks (2x/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-meter Walk Test [10mWT]), walking endurance (6 Minute Walk Test [6MWT]), leg strength/transfers (Five Times Sit to Stand Test [5xSTS], 30 Second Sit to Stand Test [30CST]), and fatigue (Modified Fatigue Impact Scale [MFIS]) were assessed every four weeks. RESULTS Improvements in 10mWT (fast) occurred earlier for low-load RT + BFR (1.31 ± 0.24 to 1.79 ± 0.53 m/s from week 0 to 8; p = 0.005) than heavy-load RT (1.19 ± 0.31 to 1.63 ± 0.58 m/s from week 4 to 12; p = 0.005). MFIS was lower for low-load RT + BFR (16.25 ± 15.59 au) compared to heavy-load RT (32 ± 13.63 au) after 4 weeks (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 5xSTS 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.