A validity and reliability study of pressure prescription methods for upper extremity blood flow restriction training

BACKGROUND: Blood flow restriction training has recently been shown to provide more muscle hypertrophy and endurance than exercises without blood flow restriction. However, there are no guidelines on prescribing the pressure for restriction. So we aimed to compare already used and possible methods for occlusion pressure determination with the gold standard pulsed-wave Doppler ultrasonography.METHODS: With the participation of 44 healthy volunteers and a manual pressure pneumatic cuff, occlusion pressures of the dominant side brachial artery were determined by multiple methods. Results of Tuncalı and Hong-Yun Liu estimation formulas, fingertip oximeter device, perceived tightness scale, and capillary refill time prolongation methods were compared with the gold standard Doppler ultrasonography results.RESULTS: There was no significant difference between the fingertip oximeter device and Doppler ultrasonography measurements (131.5±10.2 vs. 130.4±12.0; P=0.168). For the other methods, statistically significant differences were found compared to the gold standard method.CONCLUSIONS: For upper extremity blood flow restriction training, the determination of occlusion pressure with a pulse oximeter device is a reliable and valid method. The subjective tightness scale is not a valid and reliable method in prescribing pressure, and its use in prescribing pressure for blood flow restricted exercise does not seem appropriate. Tuncalı and the Hong-Yun Liu estimation formulas have not been determined as valid methods. Determination of occlusion pressure based on the point where the capillary refill time exceeds 3 seconds gives consistent results in repeated measurements but provides undesirably high pressures.