Physical therapists are employing a unique method of exercise addressing fatigue that multiple sclerosis (MS) patients often encounter.

In fact, the use of blood-flow restriction training (BFRT) has exploded over the last three years.

The authors of a new case study published in the journal Physical Therapy hypothesize that BFRT can result in significant muscle and strength gains without causing undue exhaustion for MS patients.

BFRT originated in Japan in the late 1960s. The U.S. Department of Defense began using the exercise method in 2014 to help soldiers with limb salvage. The technique involves the use of low-level resistance training (sometimes just against gravity) of a limb while using a medical-grade tourniquet to partially impede blood flow.

Lower weight training produces less heat for patients — a known trigger for fatigue.

The case study protocol was based on multi-institutional 2019 BFRT guidelines from the journal Frontiers in Physiology. The new paper documents the athletic improvement of a 54-year-old woman who 13 years prior had been diagnosed with primary progressive MS.

Previously athletic, the patient had made significant gains with standard physical therapy but then plateaued. BFRT helped her make further strength and functional improvements, according to the study.

Understanding BFRT Benefits

“I really felt like I was able to push to my limit,” the patient said in the study. “Sometimes I can’t exercise at high enough intensity because of weakness or fatigue in my legs. … I was able to reach that good state of exhaustion where I wasn’t able to before.”

BFRT can result in significant changes in strength and muscle mass comparable to that of high-intensity training. The results also appear to occur faster, in just one to three weeks.

Post-operative patients have found success with BFRT when standard strength training is not an option. It’s been well researched in healthy individuals and the body of study continues to grow in patients with other chronic neurological conditions, such as Parkinson’s disease.

Careful patient screening is important prior to implementing BFRT, according to the case study. For example, patients with uncontrolled high blood pressure and clotting disorders should avoid the treatment. Patients should be referred to physical therapists trained in BFRT and who use the proper medical-grade equipment.