Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise

Abstract

Objectives: This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury. Study design: Pilot randomized clinical trial. Patients and methods: Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant’s contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences. Results: The study revealed a significant increase in participants’ forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen’s d = –6.32, 95% CI –8.34, –6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient’s Global Impression of Change score of 2.2 reflected overall improvements in participants’ daily activities and health status. Conclusion: This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.

Keywords

• spinal cord injury
• exercise
• blood flow restriction
• BFR
• low-intensity
• overuse