Use of blood flow restriction and electrical stimulation in a patient with transverse myelitis: a case report

Transverse myelitis (TM) is a rare inflammatory disorder of the spinal cord resulting in neurological impairments that impact motor function and mobility. Blood flow restriction (BFR) training has emerged as a feasible intervention in neurologic populations to improve strength and functional performance. Recent studies suggest that combining BFR with neuromuscular electrical stimulation (NMES) may further enhance outcomes. To evaluate the effects of an 8-week, low-intensity lower-extremity resistance training program incorporating BFR (2×/week for 4 weeks) followed by combined BFR+NMES (2×/week for 4 weeks) on functional performance in a patient with chronic TM. The patient was seen for a total of 17 visits. A 31-year-old male with a 17-year history of TM presented with significant left lower extremity weakness, functional mobility limitations, and challenges navigating stairs and walking long distances. His primary goal was to improve his functional mobility. Post-intervention assessments demonstrated improvement across multiple functional performance measures. The patient's gait speed with the 10-Meter Walk Test (10MWT) increased from 1.17 to 1.43 m/s (MDC 0.13 m/s), Timed Up and Go (TUG) time improved by 17.5% (MCID 10-15%), and his 30-Second Sit-to-Stand (30STS) performance increased by two repetitions (MDC 1.13). Improvements were also seen in the Patient-Specific Functional Scale (PSFS) and the SF-36. The findings suggest that BFR, alone or in combination with NMES, may improve function in chronic TM patients with lower extremity weakness. BFR appears to offer a promising approach for individuals with neurological conditions where traditional high-intensity resistance training is limited.