{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T12:34:08Z","timestamp":1791894848210,"version":"4.3.4"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Blood flow restriction (BFR) training, in which an inflatable cuff partially occludes blood flow around the proximal portion of a limb, coupled with low-intensity resistance training (LIRT) has resulted in gains comparable with traditional progressive resistive exercise in healthy populations. The use of BFR with LIRT may enable people with multiple sclerosis (MS) to improve strength without an increase in fatigue. The purpose of this case report is to describe the use of a BFR\/LIRT program for a person with MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The patient was a 54-year-old woman with a 13-year history of primary progressive MS with an Extended Disability Severity Score of 3.0 out of 10. She received a BFR\/LIRT program for both lower extremities biweekly for 12\u00a0weeks. Outcomes measured at baseline and at 6 and 12\u00a0weeks included the 12-item Multiple Sclerosis Walking Scale (MSWS-12), Fatigue Severity Scale, Patient-Specific Functional Scale (PSFS) (goals: running for exercise and pleasure for 45\u00a0minutes, 100% confidence in negotiating a flight of stairs, confidently and safely drive without restriction), and 14 lower extremity strength tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The intervention was well tolerated without adverse events. After 6\u00a0weeks, the MSWS-12 score improved; however, it did not exceed minimum detectable change (MDC). Fatigue Severity Scale was unchanged. All PSFS goals improved beyond MDC, and improvements in strength exceeded MDC in 2 out of 14 tests. After 12\u00a0weeks, MSWS-12 improvements persisted and the Fatigue Severity Scale score improved, but neither exceeded MDC. The PSFS improvements persisted. There were improvements exceeding MDC for 8 out of 14 strength tests. The remaining 6 strength tests improved but did not exceed MDC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The patient had measurable improvements following the use of a BFR\/LIRT program. BFR\/LIRT may be an option for strength training in people with MS; however, research is needed to determine its safety and effectiveness across the population of people with MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Traditional physical therapist interventions for people with MS have been shown to be beneficial; however, their usefulness has been limited by fatigue. A growing body of literature has demonstrated the effects of a BFR\/LIRT program on strength and other measures of physical function in healthy populations and those with chronic disease. This case report adds missing information to the existing literature and suggests directions for research on the effectiveness of BFR\/LIRT in people with primary progressive MS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>Blood flow restriction, which has been used to help improve strength in healthy adults and in some people with chronic disease, applies pressure around the arm or leg to limit the flow of blood to that body part during exercise, helping to reduce fatigue. Blood flow restriction coupled with low-intensity strengthening exercises can be used for a person with MS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ptj\/pzaa224","type":"journal-article","created":{"date-parts":[[2020,12,19]],"date-time":"2020-12-19T02:53:50Z","timestamp":1608346430000},"source":"Crossref","is-referenced-by-count":23,"title":["Blood-Flow Restriction Training for a Person With Primary Progressive Multiple Sclerosis: A Case Report"],"prefix":"10.1093","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2751-8814","authenticated-orcid":false,"given":"Evan T","family":"Cohen","sequence":"first","affiliation":[{"name":"Rutgers , The State University of New Jersey, Blackwood, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Cleffi","sequence":"additional","affiliation":[{"name":"RWJ Sports Physical Therapy , Princeton, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Ingersoll","sequence":"additional","affiliation":[{"name":"Rutgers , The State University of New Jersey, Blackwood, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herb I","family":"Karpatkin","sequence":"additional","affiliation":[{"name":"Hunter College \u2013 City University of New York , New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"2023011706561355300_ref1","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1212\/WNL.0000000000007035","article-title":"The prevalence of MS in the United States: a population-based estimate using health claims data","volume":"92","author":"Wallin","year":"2019","journal-title":"Neurology"},{"key":"2023011706561355300_ref2","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S1474-4422(18)30443-5","article-title":"Global, regional, and national burden of multiple sclerosis 1990\u20132016: a systematic analysis for the global burden of disease study 2016","volume":"18","author":"Wallin","year":"2019","journal-title":"Lancet"},{"key":"2023011706561355300_ref3","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.3109\/09638288.2013.854841","article-title":"Prevalence of joint contractures and muscle weakness in people with multiple sclerosis","volume":"36","author":"Hoang","year":"2014","journal-title":"Disabil Rehabil"},{"key":"2023011706561355300_ref4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.3233\/NRE-130958","article-title":"Relationship between lower extremity isometric muscle strength and standing balance in patients with multiple sclerosis","volume":"33","author":"Citaker","year":"2013","journal-title":"NeuroRehabil"},{"key":"2023011706561355300_ref5","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1177\/1352458512444497","article-title":"The relationship between upper leg muscle strength and walking capacity in persons with multiple sclerosis","volume":"19","author":"Broekmans","year":"2013","journal-title":"Mult Scler"},{"key":"2023011706561355300_ref6","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.msard.2015.01.002","article-title":"Relationship between muscle strength parameters and functional capacity in persons with mild to moderate degree multiple sclerosis","volume":"4","author":"Kj\u00f8lhede","year":"2015","journal-title":"Mult Scler Relat Disord"},{"key":"2023011706561355300_ref7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000000411","article-title":"A systematic review and meta-analysis of strength training in individuals with multiple sclerosis or Parkinson disease","volume":"94","author":"Cruickshank","year":"2015","journal-title":"Medicine"},{"key":"2023011706561355300_ref8","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1177\/1352458506073780","article-title":"Multiple sclerosis and brief moderate exercise. 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