Related Experiment Video
Updated: Mar 2, 2026

Tilt Testing with Combined Lower Body Negative Pressure: a "Gold Standard" for Measuring Orthostatic Tolerance
Published on: March 21, 2013
The effect of back and feet support on oscillometric blood pressure measurements
Jennifer S Ringrose1, Jonathan Wong, Farahnaz Yousefi
1aDepartment of Medicine, University of Alberta bAlberta Diabetes Institute cMazankowski Heart Institute, Edmonton, Alberta, Canada.
Background/Objective:
Recommendations to support the back and feet during blood pressure (BP) measurement are not always followed in clinical practice. Our objective was to determine to what extent back and feet support affects mean oscillometric BP measurements.
Participants And Methods:
Eighty-five consecutive, consenting participants 18 years or older with systolic BP readings 80-220 mmHg and diastolic BP readings 50-120 mmHg and arm circumferences of 25-43 cm were recruited. BP was measured using an Omron HEM 907 oscillometric device. Back and feet support were examined independently. First, while the feet were supported, two sets of three BP readings were taken in random order: one with the back supported and one with the back unsupported. Next, with the back supported, two sets of three BP readings were taken in random order: one with the feet dangling and one with feet supported.
Results:
The mean age of the participants was 52.0±20.7 years and the mean arm circumference was 31.0±3.2 cm; 62% were women and 49% had hypertension. The mean BP levels with the back unsupported were slightly higher than those with the back supported (119.8±15.5/69.9±8.9 vs. 119.2±16.4/68.2±8.8 mmHg; difference of 0.7±4.9/1.8±3.0; P=0.21 for systolic and <0.0001 for diastolic comparisons). The mean BP levels with feet dangling were slightly lower than with feet supported (120.3±16.3/72.6±8.9 vs. 121.2±16.1/72.9±8.6 mmHg; difference of -0.9±4.1/-0.3±2.8; P=0.04 for systolic and <0.36 for diastolic comparisons). Systolic BP differences were greater than or equal to 5 mmHg in 34% (back phase) and 23% (feet phase) of the participants.
Conclusion:
Provision of back and feet support has a small effect on the mean oscillometric BP. The magnitude of effect is greatest on diastolic BP when the back is unsupported.
More Related Videos
Related Concept Videos
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
Assessment of blood pressure in brachial artery(two-step method)
Pre-Procedural Guidelines for Assessing Blood Pressure
Measurement of Blood Pressure
Equipments Used To Measure Blood Pressure
This invasive approach involves cannulating a peripheral artery. During each cardiac contraction, pressure generates mechanical motion within the catheter, transmitted through rigid, fluid-filled tubing to a transducer. This transducer converts mechanical motion into electrical signals displayed as waveforms on a monitor. An automatic flushing system prevents blood backflow. Due to the potential risk of unexpected arterial blood loss, this method is primarily used in intensive...

