Background Remote ischaemic preconditioning (RIPC) is the exposure of body parts to brief periods of circulatory occlusion and reperfusion. Recent studies have also shown that RIPC can improve exercise performance in healthy individuals. Objective This study aimed to assess the effect of RIPC on walking in people with multiple sclerosis (MS). Methods This was a double-blind randomised controlled clinical trial. We used three cycles of RIPC delivered by occluding the upper arm with a blood pressure (BP) cuff inflated to a pressure of 30 mm Hg above the systolic BP. In patients in the sham intervention group, the BP cuff was inflated only to 30 mm Hg below diastolic BP. Outcome measures included the Six-Minute Walk Test (6MWT), gait speed, the Borg rate of perceived exertion (RPE) scale, the tolerability of the RIPC using a Numerical Rating Scale for discomfort from 0 to 10, and adverse events. We identified responders meeting the minimal clinically important difference (MCID) established in the literature in each group. Results Seventy-five participants completed the study (RIPC: 38 and Sham: 37). The distance walked during the 6MWT improved by 1.9% in the sham group and 5.7% in the RIPC group (p=0.012). The number of responders meeting MCID criteria in the RIPC group was significantly greater compared with the sham intervention group. No serious adverse events occurred. Conclusion Single cycle of RIPC resulted in immediate improvement in walking distances during 6MWT in people with MS. Trial registration numbers [NCT03153553][1] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03153553&atom=%2Fbmjno%2F2%2F1%2Fe000022.atom

中文翻译：

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远程缺血预处理对多发性硬化患者行走的影响：双盲随机对照试验

背景 远程缺血预处理 (RIPC) 是将身体部位暴露于短暂的循环闭塞和再灌注期。最近的研究还表明，RIPC 可以提高健康个体的运动表现。目的 本研究旨在评估 RIPC 对多发性硬化症 (MS) 患者步行的影响。方法这是一项双盲随机对照临床试验。我们使用了三个循环的 RIPC，通过将血压 (BP) 袖带充气至高于收缩压 30 mm Hg 的压力来封闭上臂。在假干预组的患者中，血压袖带仅充气至低于舒张压 30 mm Hg。结果测量包括六分钟步行测试 (6MWT)、步态速度、博格感知运动率 (RPE) 量表、使用数值评定量表对 0 到 10 的不适和不良事件进行 RIPC 的耐受性。我们在每组中确定了满足文献中确定的最小临床重要差异 (MCID) 的响应者。结果 75 名参与者完成了研究（RIPC：38 和 Sham：37）。在 6MWT 期间，假手术组的步行距离提高了 1.9%，RI​​PC 组提高了 5.7%（p=0.012）。与假干预组相比，RIPC 组符合 MCID 标准的应答者数量显着增加。没有发生严重的不良事件。结论 RIPC 的单周期导致 MS 患者在 6MWT 期间的步行距离立即得到改善。试用注册号 [NCT03153553][1] [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT03153553&