Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial

Background:  Claudication  is  a  common  and  debilitating  symptom  of  peripheral  artery  disease,  resulting  in  poor  exercise performance and quality of life (QoL). Supervised exercise programs are an effective rehabilitation for patients with claudication, but they are poorly adhered to, in part due to the high pain and effort associated with walking, aerobic, and resistance exercise. Low-intensity resistance exercise with blood flow restriction (BFR) represents an alternative exercise method for individuals who are intolerant to high-intensity protocols. The aim of this study was to evaluate the feasibility of a supervised BFR program in patients with claudication. Methods: Thirty patients with stable claudication completed an 8-week supervised exercise program and were randomized to either BFR (n= 15) or a control of matched exercise without BFR (control; n= 15). Feasibility, safety, and efficacy were assessed. Results: All success criteria of the feasibility trial were met. Exercise adherence was high (BFR = 78.3%, control = 83.8%), loss to follow up was 10%, and there were no adverse events. Clinical improvement in walking was achieved in 86% of patients in the BFR group but in only 46% of patients in the control group. Time to claudication pain during walking increased by 35% for BFR but was unchanged for the control. QoL for the BFR group showed improved mobility, ability to do usual activities, pain, depression, and overall health at follow up. Conclusion: A supervised blood flow restriction program is feasible in patients with claudication and has the potential to increase exercise performance, reduce pain, and improve QoL. (Clinicaltrials.gov Identifier: NCT04890275)