Feasibility fo Blood Flow Restriction Training in Individuals with Down Syndrome

Authors

• Erin Simunds EdD, PT, Concordia University, St. PaulFollow
• Megan Dowdal-Osborn PT, PhD, Concordia University, Saint PaulFollow
• Emily Braesch SPT
• Reese Crowell SPT
• T Johnson SPT
• Brayden Kurth SPT
• Andrew Nordstrom SPT

Document Type

Poster

Publication Date

2026

Abstract

Intro

• Individuals with Down Syndrome (DS) demonstrate hypotonia, hypermobility, reduced muscle mass, fatigue, and cardiac anomalies, making high-intensity resistance (HIR) training challenging and potentially unsafe.^1-4
• Although moderate-to-high intensity resistance training is recommended, clear guidelines for safe load progression in DS are limited.
• Blood flow restriction (BFR) training allows strength gains at low loads by partially restricting venous return, producing adaptations similar to high-load training in other populations⁵
• Therefore, this study investigates the feasibility of BFR training compared to traditional progressive resistance training in young adults with DS.

Methods

• Four adults with DS, subjectively active with exercise in daily life, participated in this study.
• Completed two separate sessions of sit-to-stand (STS) movements and Romanian deadlifts (RDL). The first utilized high-intensity resistance training, while the other employed BFR training.
• Outcome measures included OMNI perceived exertion scale, International Physical Activity Questionnaire (IPAQ) Short Form, Post-session enjoyment, and an adverse symptoms interview.

Results

• Exercise Enjoyment (PACES Scale): Participants reported high enjoyment for both protocols, with slightly higher average scores after HIR (6.22 ± 0.85) compared to BFR (5.75 ± 1.03); 3 of 4 participants preferred HIR, with a mean preference difference of 0.47 points.
• Delayed Onset Muscle Soreness (DOMS, 2 days post-training): Moderate soreness was reported after both conditions, averaging 4.5 ± 1.29 (HIR) vs. 3.25 ± 2.75 (BFR) on a 0-10 NPRS scale; HIR showed a small average increase of 1.25 points compared to BFR.

Conclusion

• The study found that BFR training may be a feasible treatment option for individuals with DS.
• There were no serious adverse events, and patient-reported RPE, DOMS, and PACES scores were comparable.
• Given the limited sample size and single exposure to the intervention, these findings should be interpreted cautiously.
• Further research utilizing multi-session protocols and randomized controlled trial designs is warranted to better understand the effectiveness of BFR training in individuals with DS.

Clinical Relevance

• This study contributes to the growing evidence supporting BFR as a safe and effective strength training alternative for individuals with a wide range of neurological conditions, including Down syndrome, when supervised by a trained professional to mitigate potential adverse events.

Recommended Citation

Simunds, Erin EdD, PT; Dowdal-Osborn, Megan PT, PhD; Braesch, Emily SPT; Crowell, Reese SPT; Johnson, T SPT; Kurth, Brayden SPT; and Nordstrom, Andrew SPT, "Feasibility fo Blood Flow Restriction Training in Individuals with Down Syndrome" (2026). DPT Capstone Posters. 46.
https://digitalcommons.csp.edu/dpt-posters/46