Upper limbs total occlusion pressure assessment: <scp>D</scp>oppler ultrasound reproducibility and determination of predictive variables

Morais, André Terácio B. de; Cerqueira, Mikhail Santos; Sales, Rafael Moreira; Rocha, Taciano; Filho, Alberto Galvão de Moura

doi:10.1111/cpf.12330

Cited by 30 publications

(37 citation statements)

References 25 publications

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“…3,17,27,37,46,48,79 Currently, it is recommended that individual occlusion pressures be calculated as a percentage of the total arterial occlusion pressure (AOP), with individual protocols ranging from 60% to 80%. 35,40,69,84 The gold standard method of measuring AOP and true occlusion is Doppler ultrasound, 6,9,29,56,66 although recent investigations have begun to assess the feasibility of pulse oximetry as a lower maintenance alternative. 77,84 A previous method in the literature attempted to predict the AOP as a percentage of the brachial systolic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Patel

Kym

et al. 2020

Orthopaedic Journal of Sports Medicine

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Background: Low-load blood flow restriction (BFR) training has attracted attention as a potentially effective method of perioperative clinical rehabilitation for patients undergoing orthopaedic procedures. Purpose: To (1) compare the effectiveness of low-load BFR training in conjunction with a standard rehabilitation protocol, pre- and postoperatively, and non-BFR interventions in patients undergoing anterior cruciate ligament reconstruction (ACLR) and (2) evaluate protocols for implementing BFR perioperatively for patients undergoing ACLR. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review of the 3 medical literature databases was conducted to identify all level 1 and 2 clinical trials published since 1990 on BFR in patients undergoing ACLR. Patient demographics from included studies were pooled. Outcome data were documented, including muscle strength and size, and perceived pain and exertion. A descriptive analysis of outcomes from BFR and non-BFR interventions was performed. Results: A total of 6 studies (154 patients; 66.2% male; mean ± SD age, 24.2 ± 3.68 years) were included. Of these, 2 studies examined low-load BFR as a preoperative intervention, 1 of which observed a significant increase in muscle isometric endurance ( P = .014), surface electromyography of the vastus medialis ( P < .001), and muscle blood flow to the vastus lateralis at final follow-up ( P < .001) as compared with patients undergoing sham BFR. Four studies investigated low-load BFR as a postoperative intervention, and they observed significant benefits in muscle hypertrophy, as measured by cross-sectional area; strength, as measured by extensor torque; and subjective outcomes, as measured by subjective knee pain during session, over traditional low-load resistance training (all P < .05). BFR occlusion periods ranged from 3 to 5 minutes, with rest periods ranging from 45 seconds to 3 minutes. Conclusion: This systematic review found evidence on the topic of BFR rehabilitation after ACLR to be sparse and heterogeneous likely because of the relatively recent onset of its popularity. While a few authors have demonstrated the potential strength and hypertrophy benefits of perioperative BFR, future investigations with standardized outcomes, long-term follow-up, and more robust sample sizes are required to draw more definitive conclusions.

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Section: Discussionmentioning

confidence: 99%

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Patel

Kym

et al. 2020

Orthopaedic Journal of Sports Medicine

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“…The TOP of dominant arm was determined as the lowest pressure necessary to occlude completely the blood flow, and the partial occlusion pressure was set as the value corresponding to 50% of TOP. The complete proceedings (i.e., the sequence of insufflations until to achieve the TOP) was described by Morais et al [21] which found a good reproducibility for the TOP determination. The TOP determination was carried out only one time for each subject.…”

Section: Total Occlusion Pressure Determinationmentioning

confidence: 99%

Time to failure and neuromuscular response to intermittent isometric exercise at different levels of vascular occlusion: a randomized crossover study

Cerqueira

Pereira

Rocha

et al. 2017

Int J Appl Exerc Physiol

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ABSTRACT:Objectives: The purpose this study was to investigate the effects of different vascular occlusion levels (total occlusion (TO), partial occlusion (PO) or free flow (FF)) during intermittent isometric handgrip exercise (IIHE) on the time to failure (TF) and the recovery of the maximum voluntary isometric force (MVIF), median frequency (EMGFmed) and peak of EMG signal (EMGpeak) after task failure. Methods: Thirteen healthy men (21 ± 1.71 year) carried out an IIHE until the failure at 45% of MVIF with TO, PO or FF. Occlusion pressure was determined previously to the exercise. The MVIF, EMGFmed and EMGpeak were measured before and after exercise. Results: TF was significantly different (p < 0.05) among all investigated conditions: TO (150 ± 68s), PO (390 ± 210s) and FF (510 ± 240s). The MVIF was lower immediately after IIHE, remaining lower eleven minutes after failure in all cases (p <0.05), when compared to pre exercise. There was a greater force reduction (p <0.05) one minute after the failure in the PO (-45.8%) and FF (-39.9%) conditions, when compared to TO (-28.1%). Only the PO condition induced lower MVIF (p <0.05) than in the TO, eleven minutes after the task failure. PO induced a greater reduction in EMGFmed compared TO and greater increase in EMGpeak, when compared to TO and FF (p <0.05). Conclusions: TO during IIHE lead to a lower time to failure, but a faster MVIF recovery, while the PO seems to be associated to a slower neuromuscular recovery, when compared to other conditions.

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“…Calculation of arterial occlusive pressure (AOP) involves determination of the pressure required to fully occlude arterial flow to the involved limb ( AORN Recommended Practices Committee, 2007 ). This is most often achieved using Doppler ultrasound ( Bezerra de Morais et al, 2016 ) and can be used to prescribe pressure at a relative percentage of AOP to standardise the level of occlusion across cohorts ( Laurentino et al, 2012 ; Hughes et al, 2017 ; Patterson et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Influence and reliability of lower-limb arterial occlusion pressure at different body positions

Hughes

Jeffries

Waldron

et al. 2018

PeerJ

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BackgroundTotal arterial occlusive pressure (AOP) is used to prescribe pressures for surgery, blood flow restriction exercise (BFRE) and ischemic preconditioning (IPC). AOP is often measured in a supine position; however, the influence of body position on AOP measurement is unknown and may influence level of occlusion in different positions during BFR and IPC. The aim of this study was therefore to investigate the influence of body position on AOP.MethodsFifty healthy individuals (age = 29 ± 6 y) underwent AOP measurements on the dominant lower-limb in supine, seated and standing positions in a randomised order. AOP was measured automatically using the Delfi Personalised Tourniquet System device, with each measurement separated by 5 min of rest.ResultsArterial occlusive pressure was significantly lower in the supine position compared to the seated position (187.00 ± 32.5 vs 204.00 ± 28.5 mmHg, p < 0.001) and standing position (187.00 ± 32.5 vs 241.50 ± 49.3 mmHg, p < 0.001). AOP was significantly higher in the standing position compared to the seated position (241.50 ± 49.3 vs 204.00 ± 28.5 mmHg, p < 0.001).DiscussionArterial occlusive pressure measurement is body position dependent, thus for accurate prescription of occlusion pressure during surgery, BFR and IPC, AOP should be measured in the position intended for subsequent application of occlusion.

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Upper limbs total occlusion pressure assessment: Doppler ultrasound reproducibility and determination of predictive variables

Cited by 30 publications

References 25 publications

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review

Time to failure and neuromuscular response to intermittent isometric exercise at different levels of vascular occlusion: a randomized crossover study

Influence and reliability of lower-limb arterial occlusion pressure at different body positions

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