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In a randomized sham\u2010controlled trial, 21 participants (age\u2009\u2265\u200918\u2009years, SCI duration \u2265\u20091\u2009year, knee extensor strength grade 2\u20134, ASIA A\u2010D) were randomized to either 45\u2010min LL\u2010BFRE (<jats:italic>n<\/jats:italic>\u2009=\u200911) or sham BFRE (<jats:italic>n<\/jats:italic>\u2009=\u200910) twice\/week for 8\u2009weeks. The exercise protocol consisted of four sets (30\u2009\u00d7\u200915\u2009\u00d7\u200915\u2009\u00d7\u200915 repetitions) of unilateral seated leg extensions and leg curls at 30%\u201340% of 1RM performed with pneumatic cuffs applied proximally on the trained limb and inflated to 40% of total arterial occlusion pressure (BFRE) or non\u2010inflated (sham exercise). Maximal voluntary isometric quadriceps and hamstring muscle strength, quadriceps muscle thickness, thigh circumference, and physical function were assessed at baseline, after 4 and 8\u2009weeks of training and at 4\u2010week follow\u2010up. No significant between\u2010group differences were found between BFRE and sham exercise in quadriceps or hamstring muscle strength, 10\u2010m walking test, timed up &amp; go, 6\u2010min walking test or the spinal cord independence measure. In contrast, a significant between\u2010group difference favoring BFRE was present for muscle thickness and thigh circumference from baseline to 4\u2010week follow\u2010up (0.76\u2009cm (95% CI: 0.32; 1.20, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and 2.42\u2009cm (0.05; 4.79, <jats:italic>p<\/jats:italic>\u2009=\u20090.05), respectively). In conclusion, there was no significant difference in the effect of LL\u2010BFRE and sham exercise on muscle strength and physical function in individuals with SCI. However, significant increases in muscle thickness and thigh circumference were observed in favor of BFRE.<\/jats:p><jats:p><jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> identifier: NCT03690700.<\/jats:p>","DOI":"10.1111\/sms.14759","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T08:46:26Z","timestamp":1733388386000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of Blood Flow Restriction Exercise for Improving Lower Limb Muscle Strength and Function in Chronic Spinal Cord Injury: A Randomized Controlled Trial"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-9175","authenticated-orcid":false,"given":"Anette Bach","family":"J\u00f8nsson","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Centre of Western Denmark Hammel Neurorehabilitation Centre and University Research Clinic  Viborg Denmark"},{"name":"Department of Clinical Medicine, Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Krogh","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Centre of Western Denmark Hammel Neurorehabilitation Centre and University Research Clinic  Viborg Denmark"},{"name":"Department of Clinical Medicine, Health Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Lillelund","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Centre of Western Denmark Hammel Neurorehabilitation Centre and University Research Clinic  Viborg Denmark"},{"name":"Department of Clinical Medicine, Health Aarhus University  Aarhus 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