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

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Abstract

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.

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Acknowledgements

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.

Funding

This study was funded by NIH R01HD085930.

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Authors and Affiliations

  1. Program in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park, Saint Louis, MO, 63108, USA

    Ellen N. Sutter, Anna E. Mattlage, Marghuretta D. Bland, Kendra M. Cherry-Allen, Elinor Harrison, Swati M. Surkar & Catherine E. Lang

  2. Louisiana State University School of Medicine, New Orleans, LA, USA

    Jeffrey M. Gidday

  3. Division of Biostatistics, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park, Saint Louis, MO, 63108, USA

    Ling Chen

  4. Department of Psychiatry, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park, Saint Louis, MO, 63108, USA

    Tamara Hershey

  5. Department of Neurology, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park, Saint Louis, MO, 63108, USA

    Jin-Moo Lee

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  1. Ellen N. Sutter
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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.

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Sutter, E.N., Mattlage, A.E., Bland, M.D. et al. Remote Limb Ischemic Conditioning and Motor Learning: Evaluation of Factors Influencing Response in Older Adults. Transl. Stroke Res. 10, 362–371 (2019). https://doi.org/10.1007/s12975-018-0653-8

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