Translational Stroke Research

, Volume 10, Issue 4, pp 362–371 | Cite as

Remote Limb Ischemic Conditioning and Motor Learning: Evaluation of Factors Influencing Response in Older Adults

  • Ellen N. Sutter
  • Anna E. Mattlage
  • Marghuretta D. Bland
  • Kendra M. Cherry-Allen
  • Elinor Harrison
  • Swati M. Surkar
  • Jeffrey M. Gidday
  • Ling Chen
  • Tamara Hershey
  • Jin-Moo Lee
  • Catherine E. LangEmail author
Original Article


Remote limb ischemic conditioning (RLIC) is a clinically feasible method of promoting tissue protection against subsequent ischemic insult. Recent findings from our lab demonstrated that RLIC robustly enhances motor learning in young, healthy humans. The next step is to determine which individuals would receive maximum benefit from RLIC before applying these findings to clinical rehabilitation populations such as stroke. Numerous factors, such as age, sex, body mass index (BMI), and cardiovascular comorbidities may influence the response. Sixty-nine participants aged 40–80 were randomized to receive either RLIC (n = 33) or sham (n = 36) conditioning. Participants underwent seven consecutive sessions consisting of RLIC or sham conditioning with a blood pressure cuff on the upper extremity and motor training on a stability platform balance task, with two follow-up sessions. Balance change (post-test–pre-test) was compared across participants, groups, and the factors of age, sex, BMI, and comorbidities. Participants in both groups improved their performance on the balance task from pre- to post-test. Overall balance change was independently associated with age and BMI. There was no difference in balance change between RLIC and Sham groups. However, RLIC significantly enhanced balance performance in participants with no comorbidities. Compared with our previous study in young adults, middle-aged and older adults demonstrated smaller improvements on the balance task. RLIC enhanced learning in middle-aged and older adults only in the absence of pre-defined comorbidities. RLIC may be a promising tool for enhancing motor recovery, but the accumulation of comorbidity with age may decrease its effectiveness.


Ischemic preconditioning Psychomotor performance Comorbidity Cardiovascular disease 



The authors thank Adrianna Samatmanivong for assistance with data collection, and the study participants for generously giving their time. This study was funded by the National Institute of Health R01 HD085930.


This study was funded by NIH R01HD085930.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ellen N. Sutter
    • 1
  • Anna E. Mattlage
    • 1
  • Marghuretta D. Bland
    • 1
  • Kendra M. Cherry-Allen
    • 1
  • Elinor Harrison
    • 1
  • Swati M. Surkar
    • 1
  • Jeffrey M. Gidday
    • 2
  • Ling Chen
    • 3
  • Tamara Hershey
    • 4
  • Jin-Moo Lee
    • 5
  • Catherine E. Lang
    • 1
    Email author
  1. 1.Program in Physical TherapyWashington University School of MedicineSaint LouisUSA
  2. 2.Louisiana State University School of MedicineNew OrleansUSA
  3. 3.Division of BiostatisticsWashington University School of MedicineSaint LouisUSA
  4. 4.Department of PsychiatryWashington University School of MedicineSaint LouisUSA
  5. 5.Department of NeurologyWashington University School of MedicineSaint LouisUSA

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