Blood Flow Restriction Circuit Training Model Improves Gait Speed and Lower Limb Muscle in Adults Over 60

Blood flow restriction (BFR) training is a low intensity modality capable of inducing neuromuscular and functional adaptations. While BFR has been implemented using isolated resistance or walking protocols in older adults, less is known about the effect of BFR application to popular circuit-based training modalities that integrate multi- exercise strength training, cardiovascular, and muscular endurance. PURPOSE: This study evaluated the effects of a 6-week BFR circuit training (BFRT) program on functional performance and thigh muscle cross-sectional area in healthy adults over 60, compared to a health education control group. METHODS: 45 healthy adults ≥60 years were randomly assigned to either BFRT (n=22; 3 males) or control group (CON) which received three health-education lectures with no structured exercise (n=23; 8 males). The BFRT group completed supervised upper and lower body resistance training two times per week for 60 minutes, and BFR walking at home two times per week for 20 minutes for 6 weeks. Primary outcomes included, thigh muscle cross-sectional area (CSA), 5-meter gait speed (5mGS), time up and go (TUG), hand grip strength (HG), and 30-second sit-to-stand (30STS). RESULTS: The BFRT group had significantly greater improvements in CSA (0.17 ± 0.06 cm, p < 0.01) and 5mGS (0.27 ± 0.74 m/s, p < 0.01) compared to CON. Although statistical significance between groups was not reached for any of the remaining variables (all p > 0.05), the BFRT group experienced larger improvements in 30STS (3 ± 1 repetitions vs. 1 ± 1 repetition), HG (2.42 ± 1.34 kg vs. 0.45 ± 1.31 kg) and TUG (-0.65 ± 0.25 seconds vs. - 0.13 ± 0.25 seconds) compared to the CON group. CONCLUSION: 6 weeks of blood flow restriction circuit training resulted in significant increases in thigh muscle cross-sectional area and gait speed in healthy adults over 60 years of age. While the remaining functional outcomes did not reach statistical significance, favorable trends in performance were observed in the BFRT group. These findings suggest that circuit BFR training is a feasible and effective strategy to promote lower limb muscle hypertrophy and improve gait in older adults.