Objective To investigate the effects of blood flow restriction (BFR) training on muscle strength, physical function, functional mobility, and activities of daily living (ADL) in hospitalized older adults with sarcopenia, and to compare its efficacy with that of traditional resistance training (RT), thereby providing a research basis for the development of clinical rehabilitation strategies.

Methods In this randomized controlled trial, 40 hospitalized older adults clinically diagnosed with sarcopenia were enrolled. By using a computer-generated randomization sequence, the participants were randomly assigned at a 1∶1 ratio to an experimental group (n = 20) receiving BFR training or a control group (n = 20) receiving RT. Both groups underwent a 12-week supervised program, with training sessions conducted 3 times per week. Outcome measures were assessed at baseline, 4 weeks, and 12 weeks. The primary outcome measure was muscle strength, assessed by dominant-hand grip strength. Secondary outcomes included physical function assessed with the Short Physical Performance Battery (SPPB), functional mobility assessed by the 6-meter (6-m) gait speed and the Timed Up and Go (TUG) test, and ADL assessed with the Modified Barthel Index (MBI).

Results No participants were lost to follow-up, and no adverse events were reported. After 4 weeks of intervention, grip strength improved significantly in both groups compared with the baseline data (all P < 0.001), with the BFR group demonstrating higher grip strength than the RT group (24.35 ± 5.43 kg vs 20.96 ± 5.25 kg), although the between-group difference was not statistically significant (P = 0.051). Regarding secondary outcomes, the BFR group showed significant improvements in SPPB and MBI scores compared with the RT group (all P < 0.05), with the most pronounced differences in TUG performance and 6-m gait speed (P < 0.01). After 12 weeks of intervention, grip strength was significantly higher in the BFR group than that in the RT group (25.25 ± 5.34 kg vs. 21.66 ± 5.19 kg; P = 0.039). Moreover, the BFR group demonstrated significantly better outcomes in SPPB score, 6-m gait speed, TUG time, and MBI score than the RT group did (all P < 0.01).

Conclusion BFR training significantly improves muscle strength, physical function, functional mobility, and ADL in hospitalized older adults with sarcopenia, showing superior efficacy compared with conventional RT.