Blood flow restriction in the upper and lower limbs is predicted by limb circumference and systolic blood pressure

To determine what factors should be accounted for when setting the blood flow restriction (BFR) cuff pressure for the upper and lower body.

One hundred and seventy one participants visited the laboratory for one testing session. Arm circumference, muscle (MTH) and fat (FTH) thickness were measured on the upper arm. Next, brachial systolic (SBP) and diastolic (DBP) blood pressure measurements were taken in the supine position. Upper body arterial occlusion was then determined using a Doppler probe. Following this, thigh circumference and lower body arterial occlusion were determined. Models of hierarchical linear regression were used to determine the greatest predictor of arterial occlusion in the upper and lower body. Two models were employed in the upper body, a Field (arm size) and a Laboratory model (arm composition).

The Laboratory model explained 58 % of the variance in arterial occlusion with SBP (β = 0.512, part = 0.255), MTH (β = 0.363, part = 0.233), and FTH (β = 0.248, part = 0.213) contributing similarly to explained variance. The Field model explained 60 % of the variance in arterial occlusion with arm circumference explaining the greatest amount (β = 0.419, part = 0.314) compared to SBP (β = 0.394, part = 0.266) and DBP (β = 0.147, part = 0.125). For the lower body model the third block explained 49 % of the variance in arterial occlusion with thigh circumference (β = 0.579, part = 0.570) and SBP (β = 0.281, part = 0.231) being significant predictors.

Our findings indicate that arm circumference and SBP should be taken into account when determining BFR cuff pressures. In addition, we confirmed our previous study that thigh circumference is the greatest predictor of arterial occlusion in the lower body.