Use of a handheld Doppler to measure brachial and femoral artery occlusion pressure.

Objective: Measurement of arterial occlusion pressure (AOP) is essential to the safe and effective use of blood flow restriction during exercise. Use of a Doppler ultrasound (US) is the "gold standard" method to measure AOP. Validation of a handheld Doppler (HHDOP) device to measure AOP could make the measurement of AOP more accessible to practitioners in the field. The purpose of this study was to determine the accuracy of AOP measurements of the brachial and femoral arteries using an HHDOP. Methods: We simultaneously measured AOP using a "gold standard" US and a HHDOP in the dominant and non-dominant arms (15 males; 15 females) and legs (15 males; 15 females). Results: There were no differences in limb circumference or limb volume in the dominant and non-dominant arms and legs between males and females or between the dominant and non-dominant arms and legs of males and females. The differences between US and HHDOP measures of AOP in the dominant and non-dominant arms and legs were either not significant or small (<10 mmHg) and of little practical importance. There were no sex differences in AOP measurements of the femoral artery (p > 0.60). Bland-Altman analysis yielded an average bias (-0.65 mmHg; -2.93 mmHg) and reasonable limits of agreement (±5.56 mmHg; ±5.58 mmHg) between US and HHDOP measures of brachial and femoral artery AOP, respectively. Conclusion: HHDOP yielded acceptable measures of AOP of the brachial and femoral arteries and can be used to measure AOP by practitioners for the safe and effective use of blood flow restriction. Due to the potential differences in AOP between dominant and non-dominant limbs, AOP should be measured in each limb.

[1]  D. Eggett,et al.  Comparison of Two Cuff Inflation Protocols to Measure Arterial Occlusion Pressure in Males and Females , 2023, Applied Sciences.

[2]  G. Millet,et al.  Differences in the limb blood flow between two types of blood flow restriction cuffs: A pilot study , 2022, Frontiers in Physiology.

[3]  K. Anderson,et al.  Overall Safety and Risks Associated with Blood Flow Restriction Therapy: A Literature Review. , 2022, Military medicine.

[4]  Andrew J Sheean,et al.  Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation , 2022, Arthroscopy, sports medicine, and rehabilitation.

[5]  S. Xergia,et al.  The Effect of Body Position and the Reliability of Upper Limb Arterial Occlusion Pressure Using a Handheld Doppler Ultrasound for Blood Flow Restriction Training , 2021, Sports health.

[6]  I. Hunter,et al.  Differences in Femoral Artery Occlusion Pressure between Sexes and Dominant and Non-Dominant Legs , 2021, Medicina.

[7]  B. Noonan,et al.  Limb occlusion pressure for blood flow restricted exercise: Variability and relations with participant characteristics. , 2020, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[8]  T. Abe,et al.  Strength testing or strength training: considerations for future research , 2020, Physiological measurement.

[9]  V. Tricoli,et al.  Validity of the Handheld Doppler to Determine Lower-Limb Blood Flow Restriction Pressure for Exercise Protocols. , 2020, Journal of strength and conditioning research.

[10]  F. Rossi,et al.  Determining the Arterial Occlusion Pressure for Blood Flow Restriction: Pulse Oximeter as a New Method Compared With a Handheld Doppler , 2020, Journal of strength and conditioning research.

[11]  J. Gifford,et al.  Effect of Cuff Pressure on Blood Flow during Blood Flow-restricted Rest and Exercise. , 2020, Medicine and science in sports and exercise.

[12]  T. Abe,et al.  Blood Flow Restricted Exercise and Discomfort: A Review. , 2020, Journal of strength and conditioning research.

[13]  T. Jakobsen,et al.  THE VALIDITY AND RELIABILITY OF THE HANDHELD OXIMETER TO DETERMINE LIMB OCCLUSION PRESSURE FOR BLOOD FLOW RESTRICTION EXERCISE IN THE LOWER EXTREMITY. , 2020, International journal of sports physical therapy.

[14]  T. Abe,et al.  Corrigendum: Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety , 2019, Front. Physiol..

[15]  B. Schoenfeld,et al.  Potential Implications of Blood Flow Restriction Exercise on Vascular Health: A Brief Review , 2019, Sports Medicine.

[16]  T. Abe,et al.  The impact of cuff width and biological sex on cuff preference and the perceived discomfort to blood-flow-restricted arm exercise , 2019, Physiological measurement.

[17]  T. Abe,et al.  The influence of biological sex and cuff width on muscle swelling, echo intensity, and the fatigue response to blood flow restricted exercise , 2019, Journal of sports sciences.

[18]  Johnny G. Owens,et al.  Why is it Crucial to Use Personalized Occlusion Pressures in Blood Flow Restriction (BFR) Rehabilitation? , 2019 .

[19]  T. Abe,et al.  An investigation into setting the blood flow restriction pressure based on perception of tightness , 2018, Physiological measurement.

[20]  F. Haddad,et al.  Comparison of the acute perceptual and blood pressure response to heavy load and light load blood flow restriction resistance exercise in anterior cruciate ligament reconstruction patients and non-injured populations. , 2018, Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine.

[21]  M. Waldron,et al.  Influence and reliability of lower-limb arterial occlusion pressure at different body positions , 2018, PeerJ.

[22]  C. Ade,et al.  Brachial blood flow under relative levels of blood flow restriction is decreased in a nonlinear fashion , 2018, Clinical physiology and functional imaging.

[23]  T. Abe,et al.  The Application of Blood Flow Restriction: Lessons From the Laboratory , 2018, Current sports medicine reports.

[24]  K. Vissing,et al.  Body position influences arterial occlusion pressure: implications for the standardization of pressure during blood flow restricted exercise , 2018, European Journal of Applied Physiology.

[25]  B. Dawson,et al.  Factors affecting occlusion pressure and ischemic preconditioning , 2018, European journal of sport science.

[26]  T. Hoogeboom,et al.  How to determine leg dominance: The agreement between self-reported and observed performance in healthy adults , 2017, PloS one.

[27]  J. Loenneke,et al.  Blood flow in humans following low-load exercise with and without blood flow restriction. , 2017, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[28]  J. Loenneke,et al.  A tale of three cuffs: the hemodynamics of blood flow restriction , 2017, European Journal of Applied Physiology.

[29]  J. Loenneke,et al.  The effects of upper body exercise across different levels of blood flow restriction on arterial occlusion pressure and perceptual responses , 2017, Physiology & Behavior.

[30]  C. Gissane,et al.  Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis , 2017, British Journal of Sports Medicine.

[31]  J. W. Ingram,et al.  The influence of time on determining blood flow restriction pressure. , 2017, Journal of science and medicine in sport.

[32]  T. Abe,et al.  Blood flow occlusion pressure at rest and immediately after a bout of low load exercise , 2016, Clinical physiology and functional imaging.

[33]  T. Abe,et al.  Influence of relative blood flow restriction pressure on muscle activation and muscle adaptation , 2016, Muscle & nerve.

[34]  T. Abe,et al.  The Influence of Cuff Width, Sex, and Race on Arterial Occlusion: Implications for Blood Flow Restriction Research , 2016, Sports Medicine.

[35]  D. Kidgell,et al.  Unilateral bicep curl hemodynamics: Low‐pressure continuous vs high‐pressure intermittent blood flow restriction , 2015, Scandinavian journal of medicine & science in sports.

[36]  T. Abe,et al.  Blood flow restriction in the upper and lower limbs is predicted by limb circumference and systolic blood pressure , 2015, European Journal of Applied Physiology.

[37]  B. Schoenfeld,et al.  Exercise and blood flow restriction. , 2013, Journal of strength and conditioning research.

[38]  T. Abe,et al.  Blood flow restriction does not result in prolonged decrements in torque , 2013, European Journal of Applied Physiology.

[39]  T. Abe,et al.  Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise , 2012, European Journal of Applied Physiology.

[40]  J. Loenneke,et al.  The Use of Occlusion Training to Produce Muscle Hypertrophy , 2009 .

[41]  T. Abe,et al.  Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects , 2007, European Journal of Applied Physiology.

[42]  J.J. Guex,et al.  Edema and Leg Volume: Methods of Assessment , 2000, Angiology.

[43]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[44]  E. Stranden A comparison between surface measurements and water displacement volumetry for the quantification of leg edema. , 1981, Journal of the Oslo city hospitals.

[45]  V L Katch,et al.  A simple antrhopometric method for calculating segmental leg limb volume. , 1974, Research quarterly.

[46]  V. Katch,et al.  The use of body weight and girth measurements in predicting segmental leg volume of females. , 1973, Human biology.

[47]  P R Jones,et al.  Anthropometric determination of leg fat and muscle plus bone volumes in young male and female adults. , 1969, The Journal of physiology.

[48]  J. Loenneke,et al.  Letter to the editor: Applying the blood flow restriction pressure: the elephant in the room. , 2016, American journal of physiology. Heart and circulatory physiology.

[49]  B. Dascombe,et al.  Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development , 2014, Sports Medicine.

[50]  R. Nagai,et al.  Hemodynamic and autonomic nervous responses to the restriction of femoral blood flow by KAATSU , 2005 .