Feasibility and acceptability of remote ischemic conditioning combined with low-intensity resistance training in older adults with mobility impairments: A randomized controlled pilot trial protocol

BACKGROUND: Rehabilitation outcomes in older individuals with mobility impairments are often suboptimal due to limited capacity for high-intensity exercise. Remote ischemic conditioning is a low-cost, non-invasive technique that may enhance physiological adaptations to exercise. OBJECTIVE: To assess the feasibility and acceptability of combining remote ischemic conditioning with low-intensity resistance exercise training in older individuals with mobility impairments, and to evaluate the feasibility of collecting plasma biomarkers. DESIGN: A randomized, blocked feasibility trial with n = 20 participants aged ≥65 years with mobility impairment, comparing high-dose remote ischemic conditioning with low-intensity resistance exercise training versus low-dose remote ischemic conditioning with low-intensity resistance exercise training over a 6-week intervention period. METHODS: Participants will undergo baseline and post-intervention assessments, including body composition, muscle strength, physical function, vascular function, exercise tolerance, and acceptability, resilience, and quality of life questionnaires. Blood samples will be collected pre- and post-remote ischemic conditioning and exercise sessions for the quantification of plasma lactate, cytokines, growth factors, oxidative stress, vascular health, and extracellular vesicles. OUTCOMES: Primary outcomes include feasibility (recruitment, retention, adherence) and acceptability (interviews, questionnaires) of the intervention. Secondary outcomes include the feasibility of biomarker collection and collecting physical activity, physical function, muscle strength and mass, exercise tolerance, quality of life, resilience, vascular function, and biomarker outcomes over the course of the study intervention. CONCLUSION: This pilot study aims to inform the design of a larger clinical trial by evaluating the feasibility of a novel remote ischemic conditioning with low-intensity resistance exercise training intervention and identifying responsive outcome measures.