Limb Occlusion Pressure For Blood Flow Restricted Exercise: Variability And Relations With Participant Characteristics

Limb occlusion pressure (LOP) has been recommended as a standard approach to administering BFR training in clinical populations. However, despite prior research showing LOP does not change much over the course of 4-8 weeks in healthy participants, other studies show LOP can change based on the time of day, position, cuff width, and even cuff bladder positioning on the limb.

In clinical practice, patients may present to the clinic at different times of day and require BFR on more than one limb, which may influence LOP assessment.  This study investigated whether assessment of LOP was reliable between different times of day and between limbs using the Delfi personalized tourniquet device (cuff width, 12 cm). Forty-two males and females participated in this study. Each reported twice to the lab separated by 3-10 days and at different times of the day to get their LOP, BP values, and thigh circumferences assessed.

Results showed group values were not different between LOP taken at different times or between legs, but at the participant level, significant values were seen between legs and LOP with a 95% confidence interval around 14 mm Hg. Interesting, this study did not support that SBP plays a role in LOP determination in the upper body, but pulse pressure and limb circumference does.

The results of this study highlight the importance of looking at individualized data compared to group means, which may paint a slightly different outlook on assessment of LOP. As clinicians, assessment of LOP takes 2 minutes maximum and the results of this study suggest that if you see clients/patients at different times of the day, LOP values may change. Whether or not this has significance on perceptual, cardiovascular and/or musculoskeletal outcomes – we’ll see (but likely not). Last, this study tried to create an algorithm for LOP, but was largely unsuccessful as the equation under- or over-predicted LOP by as much as 50 mm Hg. This highlights the fact that we should be measuring LOP!

Source:

Evin et al. (2020). Limb occlusion pressure for blood flow restricted exercise: variability and relations with participant characteristics.

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****Remember, the use of BFR training should not be based solely on a success story.  The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.

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