The Effects of Low-intensity Resistance Training with Blood Flow Restriction Versus Traditional Resistance Exercise on Lower Extremity Muscle Strength, Walking Capacity, and Balance in Ischemic Stroke Survivors: A Study Protocol for the BFR-Stroke RESILIENCE Trial

Aim: The purpose of this study will be to determine the effect of low-intensity resistance training with blood flow restriction (LIRT-BFR) on lower extremity muscle strength, balance, functional mobility, walking capacity, gait speed, anxiety, and depression in patients with stroke and to compare the results with high-intensity resistance training (HIRT). Methods: This will be a two-arm, single-blinded, randomized controlled trial (RCT) in which 32 ischemic stroke survivors will be randomized into two groups: the LIRT-BFR group and the HIRT group. Both groups will perform 3 sets of 6 resistance training for 40 minutes, 3 days a week, in addition to aerobic exercise for 5 weeks. In the LIRT-BFR group, blood flow to the active muscle was restricted by a BFR band (tourniquet) placed at the proximal end of the lower limbs. The 10-meter walk test, five-time sit-to-stand test, timed up and go test, 6-minute walk test, and Barthel index test will be the primary outcome measures. The secondary outcome measures include depression, anxiety, gait speed, stride length, cadence, adherence to treatment intervention, and adverse events. Conclusion: The results from this RCT will constitute an evidence-base for BFR training and its efficacy on lower limb strength, walking capacity, and balance performance in patients with stroke.