Blood flow restriction training prescription percentage of lower limb arterial occlusion pressure at fixed values and based on brachial systolic blood pressure

Background. Blood flow restriction (BFR) exercise is recommended with personalized pressures between 40 and 80% of arterial occlusion pressure (AOP) to ensure safety and efficacy. However, many studies use fixed pressures or personalized pressures based on brachial blood pressure, such as 130% of resting brachial systolic pressure (rbSBP), which may lead to inconsistencies. This study aimed to estimate the percentage of AOP in the thigh when using fixed pressures (e.g., 100, 200, and 300 mmHg) or 130% of SBP.

Methods. Fifty-one healthy participants (18–40 years) underwent anthropometric measurements, brachial blood pressure assessment, and AOP determination in the thigh in supine, seated, and standing positions using an 18 cm cuff. AOP measurements were randomized and compared to fixed pressures and 130% of SBP.

Results. AOP was higher than 100 mmHg in all positions, with 100 mmHg corresponding to 80.5%, 62%, and 56.9% of AOP in the supine, seated, and standing positions, respectively. Conversely, 200 mmHg exceeded AOP, reaching 160.9%, 124.2%, and 113.7% in the same positions. Compared to SBP, supine AOP was lower than 130% of rbSBP, standing AOP was higher, and seated AOP showed no significant difference (p = 0.595). In the seated and standing positions, 130% of rbSBP corresponded to 92.5% and 84.7% of AOP, respectively.

Conclusion. A fixed pressure of 100 mmHg may fall within the recommended range for BFR prescription, but findings are specific to AOP assessment with an 18 cm cuff. Personalization remains crucial for accuracy and safety.