Bilateral muscle strength symmetry and performance are improved following walk training with restricted blood flow in an elite paralympic sprint runner: Case study

Abstract Objectives Investigate the influence of 4 weeks of walk training with blood flow restriction (BFR) on muscle strength, metabolic responses, 100-m and 400-m performances in an athlete with cerebral palsy. Methods An elite Paralympic sprinter (20 years, 176 cm, 64.8 kg) who presented with moderate hemiplegic cerebral palsy (right side impaired) completed four visits before and after 4 weeks of the BFR training: 1) anthropometric measurements, familiarization of maximal voluntary contraction (MVC), and an incremental test; 2) MVC measurements; 3) 400-m performance, and 4) 100-m performance. The walk training with BFR consisted of four bouts of 5 min at 40% of maximal aerobic speed with 1 min of passive rest with complete reperfusion. Results All performance times were lower with training (100-m: 1%; 400-m: 10%), accompanied by adaptations in aerobic variables ( V ˙ O 2 max: 6%; OBLA: 24%) and running economy (9–10%). Lactic acid energy metabolism was reduced (25–27%), even in the presence of a higher lactate efflux from the previously active muscles after training. MVC (right leg: 19%; left leg: 9%) increased in both legs unevenly, decreasing the muscle strength asymmetry between limbs. Conclusions These results indicate that cardiovascular and neuromuscular adaptations can be simultaneously induced following BFR training in a paralympic sprinter.