Blood Flow Restriction Training in Multiple Sclerosis

Study Overview
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Brief Summary
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Traditional physical therapy resisted training for people with MS have been shown to be beneﬁcial; however, their usefulness has been limited by fatigue. The effect of blood flow restriction on strength and other measures of physical function was demonstrated in healthy populations and those with chronic disease. This study may add missing information to the existing literature and suggests directions for research on the effectiveness of BFR training on individuals with relapsing and remitting MS.

Detailed Description
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Multiple sclerosis patients are characterized by impaired functional capacity which is related to reduce muscle strength affecting predominantly the lower extremity. Resistance training (RT) has proven to be one of the interventions in MS patients showing a consistent and positive effect on muscle strength and on parameters directly related to lower extremity physical function (eg, walking performance and stair negotiation). Training with blood flow restriction (BFR), is an increasingly common clinical intervention among physical therapists over the past decade and consistent with the evidence. It has been investigated in people with neurological disorders including stroke and incomplete Spinal Cord Injuries. Research is limited on the use of BFR for individuals with MS.

Official Title
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(Effect of Blood Flow Restriction Training on Muscle Strength and Gait Performance in Multiple Sclerosis Patients).

Conditions
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MS

Intervention / Treatment
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* Other: strengthening ex with BFR training
* Other: strengthening ex


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients were diagnosed with MS by a neurologist according to McDonald's criteria 2010 Expanded Disability Status Scale (EDSS) scores ranging from 2.5 to 5.5 . Patient able to walk 100 meters or more. No change within MS specific medication three months from the study. Last Ms Attack from more than two months. Exclusion Criteria: Multiple sclerosis patients with other neurological or orthopedic problems. Multiple sclerosis patients with systemic problems (cardiovascular or pulmonary diseases…). Patients with cognitive impairment. Pregnant female patients. Patients in acute relapse stage. -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: The control group (A) will receive therapeutic strengthening training program for lower extremities.<br>low intensity strengthening exercise program | Other: strengthening ex<br>* Therapeutic strengthening training program for lower extremities.<br>|
| Active Comparator: The study group (B) will receive strengthening training with blood flow restriction<br>the same selected low intensity resisted exercise program as group (A) with blood flow restriction | Other: strengthening ex with BFR training<br>* Therapeutic strengthening training with blood flow restriction of trained limb.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| muscle strength | measure maximal torque production at a specified velocity of limb movement. measure torque of hip flexors , extensors , knee flexors and extensors | one week after the end of treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| gait performance by Two-dimensional (2D) Motion Analysis system | kinematic analysis of gait (step length , stride length) | one week after the end of treatment |