LOW-INTENSITY INTERVAL WALKING WITH BLOOD FLOW RESTRICTION TO IMPROVE AMBULATION AND PARTICIPATION IN A TEENAGER WITH HEMIPARESIS AND ATAXIA

Background & Purpose: Blood flow restrictive (BFR) training during low-intensity aerobic exercise improves strength and endurance in healthy adults. While the effectiveness of strengthening during BFR in adults is documented, the impact of ambulation with BFR in teenagers with neurological impairment is relatively unexplored. BFR training involves placing inflatable cuffs proximally around the active limbs at a pressure that restricts arterial blood flow and venous return. The purpose of this case study is to examine the effect of low-intensity interval walking with BFR on gait and participation.



Case Description: A 16-year-old female s/p medulloblastoma tumor resection presented with hemiparesis and ataxia. Intervention: Low-Intensity interval walking with BFR 1-2 times per week for 4 weeks. She ambulated using a gait trainer for 6-minute intervals with 3-minute standing rest breaks, during which cuffs were deflated. Intervention ended when patient reported 5/10 Rate of Perceived Exertion (RPE).

Outcome measures used: 50-foot walk test, gait speed, step length, 2-minute walk test, RPE during 2-minute walk test, 5 times sit to stand and Canadian Occupational Performance Measure (COPM).

Discussion: Low-intensity interval walking with BFR improved all measures. Minimal clinically important difference (MCID) achieved with RPE, 50-foot walk test and COPM Performance Score. Because energy expenditure directly correlates with walking speed, this patient walks with less fatigue and may use her energy for participation level activities. Further investigation is necessary to investigate the safety and effectiveness of this intervention for teenage patients.