The effects of blood flow restriction training on lower limb motor function and balance in stroke patients: a randomized clinical trial
In brief
Low-load blood-flow restriction more than doubled meaningful leg gains after stroke
In a randomized trial of 96 stroke survivors, three weeks of blood-flow-restriction walking or resistance training improved leg function, balance and mobility more than walking alone alongside standard rehabilitation. Clinically meaningful leg-function gains occurred in 34.4% with low-load resistance training versus 15.6% with walking alone; average gains were modest, and longer-term benefits remain unknown.
- Journal
- Archives of physical medicine and rehabilitation (Q1)
- Published
- 4 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Fenghao Ma, Qian Qian, Taiyang Liu, Qi Qi, Jiayou Wang, Chaoyang Guo, et al.
- PMID
- 42830125
- DOI
- 10.1016/j.apmr.2026.09.021
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 5 October 2026): Both BFR‑Walking and LL‑BFR showed greater FMA‑LE improvements than control
Abstract
OBJECTIVE: To evaluate the effects of blood flow restriction (BFR) training, delivered as BFR‑walking or low‑load resistance training with BFR (LL‑BFR), on lower limb motor function and balance in stroke survivors. DESIGN: A single-blind randomized clinical trial. SETTING: Inpatient intensive rehabilitation unit. PARTICIPANTS: Ninety-six stroke patients had a mean (SD) age of 55.80 (13.17) years, and 27% were female. INTERVENTION: Participants were allocated 1:1:1 to undergo a 3-week intervention (five sessions/week) consisting of either walking without BFR (Control), BFR-walking (120 mmHg cuff pressure), or LL-BFR (120 mmHg low-load resistance training at 20% 1RM). All received concurrent standard rehabilitation. MAIN OUTCOME MEASURES: The primary outcome was the Fugl-Meyer Assessment of Lower Extremity (FMA-LE), with secondary outcomes including the Berg Balance Scale (BBS), Timed Up and Go Test (TUG), 30-Second Sit-to-Stand Test (30sSTS), and Limits of Stability. RESULTS: Significant Group × Time interactions were found for FMA‑LE (F [2, 93.054] =8.418, P<0.001, η²p=0.153), BBS (F [2, 93.000]=4.615, P=0.012, η²p=0.090), TUG (F [2, 93.000]=9.121, P<0.001, η²p=0.164), and 30sSTS (F [2, 93.000]=26.020, P<0.001, η²p=0.359). Both BFR‑Walking (adjusted mean difference vs. control: 1.66 points; 95% CI, 0.27 to 3.04; P=0.010) and LL‑BFR (2.25 points; 95% CI, 0.86 to 3.64; P<0.001) showed greater FMA‑LE improvements than control, with no difference between BFR modalities (P=0.165). Both BFR groups outperformed control on BBS, TUG, and 30sSTS (all P<0.05). Responder analysis showed 34.4% of LL‑BFR participants achieved FMA‑LE MCID (≥4 points) versus 15.6% in control (P=0.04). No serious adverse events occurred. CONCLUSION: A 3‑week BFR‑Walking or LL‑BFR regimen improved balance and mobility beyond conventional training. Although the average improvement is modest, a significantly greater number of patients may achieve clinically meaningful improvement, warranting larger, longer‑term trials before routine clinical use.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.