Improved Aerobic Capacity in Adolescent With Long COVID Using Blood Flow Restriction Training: A Case Report

BACKGROUND: Long COVID (LC) presents with persistent symptoms such as fatigue and post-exertional malaise (PEM), limiting functional capacity. Blood flow restriction (BFR) training has shown promise in improving aerobic capacity at low intensities, potentially benefiting individuals with LC. CASE PRESENTATION: A 14-year-old female with LC, postural orthostatic tachycardia syndrome (POTS), and PEM experienced limited improvement with standard physical therapy. After gaining medical clearance, her therapist initiated a 6-week intervention combining low-intensity treadmill walking (TMW) with BFR. OUTCOME AND FOLLOW-UP: After BFR with TMW, the patient demonstrated improved walking distance, walking speed, sit-to-stand repetitions, and self-reported physical function. While overall ventilatory efficiency improved from her baseline, ventilatory inefficiency persisted, supporting continued medical management. DISCUSSION: This novel case highlights BFR as a safe, effective adjunct to aerobic training in adolescents with LC and POTS. Clinicians could consider BFR for patients with exertional intolerance, as it may enhance oxygen utilization and functional outcomes without exacerbating PEM. JOSPT Cases 2026;6(2):89-93. Epub 5 February 2026. doi:10.2519/josptcases.2026.0194