Blood flow restriction pressure recommendations: a tale of two cuffs

Arm circumference influences blood pressure even when applying the correct cuff size: Is a further correction needed?

“…Our work has centered on the idea of making this BFR stimulus relative to the individual and one way we do that is by applying the pressure relative to the size of the limb [4]. Our findings have repeatedly demonstrated that a bigger limb requires a greater pressure and this limb circumference measure has repeatedly shown to explain as much of the variance in arterial occlusion as the body composition of the limb to which the stimulus is being applied [5,6].…”

“…ACCEPTED MANUSCRIPT 4 those with larger, more muscular arms, were more likely to be classified as pre-hypertensive or hypertensive compared to smaller arms, despite, again, using the appropriate cuff size for each participant. This is a finding that turned out to be in alignment with our analyses from nationally represented data (N=33,261) from the National Health and Nutrition Examination Survey (Table 2), which demonstrated that those with greater arm circumference had higher blood pressure, despite applying the appropriate cuff size; results were unchanged when controlling for various parameters, such as age and body mass index.…”

Exercise with Blood Flow Restriction: An Updated Evidence-Based Approach for Enhanced Muscular Development

“…Logic therefore dictates that BFR should not be universally applied at an absolute pressure, but should vary relative to each individual [43]. The pressure applied should be dependent on both the cuff width and the size of the limb to which BFR is being applied [41].…”

The acute muscular response to blood flow‐restricted exercise with very low relative pressure

“…>70% 1RM) resistance training (Laurentino et al, 2012;Martin-Hernandez et al, 2013;Vechin et al, 2015). Although some researchers have applied a restrictive stimulus based on brachial systolic blood pressure measurements, it has been suggested that the application of pressure be made relative to the cuff used for BFR and to the individual, in order to ensure a similar stimulus for each participant (Loenneke et al, 2013). Although some researchers have applied a restrictive stimulus based on brachial systolic blood pressure measurements, it has been suggested that the application of pressure be made relative to the cuff used for BFR and to the individual, in order to ensure a similar stimulus for each participant (Loenneke et al, 2013).…”

“…Many BFR studies involving the upper (Jessee et al, 2016) and lower (Loenneke et al, 2012b,c) body have used absolute pressures, which could be problematic as the stimulus may not be the same for all participants. By measuring the arterial occlusion pressure (AOP) with the cuff actually used during the BFR protocol, then applying the stimulus as a percentage of that value, this ensures that the methodology is replicable, and allows investigators to compare various combinations of load and relative restriction pressures (Loenneke et al, 2013). By measuring the arterial occlusion pressure (AOP) with the cuff actually used during the BFR protocol, then applying the stimulus as a percentage of that value, this ensures that the methodology is replicable, and allows investigators to compare various combinations of load and relative restriction pressures (Loenneke et al, 2013).…”