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.
Milosovic S, Albright A, et al. • Experimental gerontology • 2026
This pilot randomized controlled trial protocol aims to assess the feasibility and acceptability of combining remote ischemic conditioning with low-intensity resistance exercise training in older adults with mobility impairments, to inform the design of a larger clinical trial.
Key Findings
Methods
The study is designed as a randomized, blocked feasibility trial comparing two doses of remote ischemic conditioning combined with low-intensity resistance exercise training.
High-dose remote ischemic conditioning with low-intensity resistance exercise training is compared against low-dose remote ischemic conditioning with low-intensity resistance exercise training.
The trial enrolls n=20 participants aged ≥65 years with mobility impairment.
The intervention period is 6 weeks in duration.
Blocked randomization design is used to assign participants to the two arms.
Background
Remote ischemic conditioning is characterized as a low-cost, non-invasive technique proposed to enhance physiological adaptations to exercise in older adults with limited capacity for high-intensity exercise.
The intervention is specifically targeted at older individuals with mobility impairments whose rehabilitation outcomes are described as 'often suboptimal due to limited capacity for high-intensity exercise.'
Remote ischemic conditioning is combined with low-intensity resistance exercise training as the novel intervention.
The approach is intended to address the rehabilitation gap in this population.
Methods
Primary outcomes of the trial are feasibility and acceptability of the combined intervention.
Feasibility is operationalized through recruitment, retention, and adherence metrics.
Acceptability is assessed through qualitative interviews and questionnaires.
These primary outcomes are designed to determine the readiness for a larger clinical trial.
Methods
Secondary outcomes include feasibility of biomarker collection and multiple physical, functional, and quality-of-life measures.
Blood samples are collected pre- and post-remote ischemic conditioning and exercise sessions.
Plasma biomarkers targeted include lactate, cytokines, growth factors, oxidative stress markers, vascular health markers, and extracellular vesicles.
Physical secondary outcomes include physical activity, physical function, muscle strength and mass, exercise tolerance, vascular function, quality of life, and resilience.
Assessments occur at baseline and post-intervention, including body composition, muscle strength, physical function, vascular function, and exercise tolerance.
Conclusions
The pilot study is explicitly designed to identify responsive outcome measures for a future larger clinical trial.
The trial 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.'
Identifying 'responsive outcome measures' is stated as a key objective alongside feasibility evaluation.
The sample size of n=20 is consistent with a pilot/feasibility study rather than a powered efficacy trial.
What This Means
This research describes the protocol for a small pilot study testing whether it is practical and acceptable to combine a technique called remote ischemic conditioning (RIC) with low-intensity strength training in older adults who have difficulty moving around. Remote ischemic conditioning involves briefly restricting and then restoring blood flow to a limb (typically using a blood pressure cuff) to trigger beneficial effects throughout the body. The study enrolls 20 people aged 65 and older and randomly assigns them to either a higher or lower dose of RIC alongside gentle resistance exercise over six weeks, measuring whether people can be recruited, whether they stick with the program, and whether they find it acceptable.
The study also tests whether researchers can successfully collect and analyze blood samples before and after exercise sessions to detect changes in biological markers such as inflammation-related proteins, growth factors, and tiny particles released by cells. Additional measurements include muscle strength, physical function, cardiovascular health, and quality of life. By gathering all of this information in a small group first, the researchers aim to work out which measurements are most useful and practical before conducting a much larger study.
This research suggests that combining remote ischemic conditioning with low-intensity exercise could be a promising approach for older adults who are unable to do high-intensity workouts — a group that often has poor outcomes from standard rehabilitation. If the pilot demonstrates that the protocol is feasible and acceptable, it would support moving forward with a larger trial that could determine whether this combination actually improves strength, mobility, and overall health in this vulnerable population.
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Milosovic S, Albright A, Hilton T, Casiano-Agosto N, Selvaraj S, Covington J, et al.. (2026). 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.. Experimental gerontology. https://doi.org/10.1016/j.exger.2026.113158