Effects of Blood Flow Restriction Training on Muscle Strength and Physical Function for Stroke-Related Sarcopenia

Effects of Blood Flow Restriction Training on Physical Performance in Individuals With Stroke-Related Sarcopenia: A Randomized Controlled Trial

Effects of Blood Flow Restriction Walking on Muscle Strength and Physical Function in Chronic Stroke Patients with Sarcopenia: A Randomized, Sham-Controlled Trial Primary Objective: To evaluate the effects of BFR walking on muscle strength and physical function in chronic stroke patients with sarcopenia, compared to sham-BFR walking.

Secondary Objective: (1) To explore the potential impact of BFR walking on muscle mass and vascular function in chronic stroke patients with sarcopenia. (2) To assess the influence of BFR walking on quality of life in chronic stroke patients with sarcopenia.

Inclusion Criteria:

• Diagnosed with chronic stroke (≥6 months post-stroke)
• Sarcopenia will be diagnosed using the Asian Working Group for Sarcopenia (AWGS) 2025 criteria, defined as the concurrent presence of low muscle strength and low appendicular skeletal muscle mass. Muscle strength will be assessed using handgrip strength measured on the non-paretic side. Low muscle strength will be defined as handgrip strength <28 kg for men and <18 kg for women aged ≥65 years, and <34 kg for men and <20 kg for women aged 50-64 years. Appendicular skeletal muscle mass will be measured using bioelectrical impedance analysis, and the appendicular skeletal muscle mass index will be calculated as appendicular skeletal muscle mass divided by height squared. Low muscle mass will be defined as an appendicular skeletal muscle mass index <7.0 kg/m² for men and <5.7 kg/m² for women aged ≥65 years, and <7.6 kg/m² for men and <5.7 kg/m² for women aged 50-64 years.

Exclusion Criteria:

• Stroke occurred within the past 6 months
• Resting systolic blood pressure > 200 mmHg
• Resting diastolic blood pressure > 100 mmHg
• Presence of implanted electronic or metallic devices that interfere with blood flow restriction cuffs
• Contraindication to bioelectrical impedance analysis (e.g., pacemaker, ICD)