Blood Flow at Different Occlusion Pressures Using Multichambered Blood Flow Restriction Cuffs in the Arm and Leg

Vehrs, PR, Richards, S, Nielsen, JR, Gardner, SD, DeSpain, N, Watkin, JH, Witney, T, Snow, GL, and Hager, RL. Blood flow at different occlusion pressures using multichambered blood flow restriction cuffs in the arm and leg. J Strength Cond Res 40(7): 747-756, 2026-The blood flow responses to increasing cuff pressure when using multichambered blood flow restriction (BFR) cuffs are not well understood. On 2 nonconsecutive days, ultrasound was used to measure unoccluded blood flow and blood flow at 8 cuff pressures in the arm (150-500 mm Hg) and 6 cuff pressures in the leg (250-500 mm Hg) using B Strong multichambered BFR cuffs in 20 healthy young adults (10 men, 10 women). Despite differences in limb circumferences, a cuff pressure of 500 mm Hg was unable to occlude blood flow in both limbs in men and women. Across the range of cuff pressures, there were significant sex differences ( p < 0.0001) in absolute (ml·min -1 ) and relative (% unoccluded) blood flow in the arm and absolute blood flow in the leg. Inflation of B Strong cuffs was unable to significantly reduce unoccluded absolute blood flow (ml·min -1 ) in the arm at all cuff pressures ( p = 0.2148-0.99). Relative blood flow in the arm was significantly reduced at all cuff pressures ( p < 0.0001) and a plateau ( p = 0.3771-0.99) occurred at cuff pressures of 200 mm Hg and above in men and 250 mm Hg and above in women. In the leg, only cuff pressures of 400 mm Hg and above ( p < 0.045) for men and 450 mm Hg and above ( p < 0.0001) in women significantly reduced absolute blood flow below unoccluded values. There was a plateau in relative blood flow between cuff pressures of 250-450 mm Hg in men and women ( p = 0.1041-0.99). Because of the wide variability in blood flow responses to increasing cuff pressures, people may have diverse experiences and outcomes with BFR training. This presents new challenges to prescribing exercise with BFR. The practical limitations of using multichambered BFR cuffs require further investigation.