Skip to main content
Log in

Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise

European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to determine the difference in cuff pressure which occludes arterial blood flow for two different types of cuffs which are commonly used in blood flow restriction (BFR) research. Another purpose of the study was to determine what factors (i.e., leg size, blood pressure, and limb composition) should be accounted for when prescribing the restriction cuff pressure for this technique. One hundred and sixteen (53 males, 63 females) subjects visited the laboratory for one session of testing. Mid-thigh muscle (mCSA) and fat (fCSA) cross-sectional area of the right thigh were assessed using peripheral quantitative computed tomography. Following the mid-thigh scan, measurements of leg circumference, ankle brachial index, and brachial blood pressure were obtained. Finally, in a randomized order, arterial occlusion pressure was determined using both narrow and wide restriction cuffs applied to the most proximal portion of each leg. Significant differences were observed between cuff type and arterial occlusion (narrow: 235 (42) mmHg vs. wide: 144 (17) mmHg; p = 0.001, Cohen’s D = 2.52). Thigh circumference or mCSA/fCSA with ankle blood pressure, and diastolic blood pressure, explained the most variance in the cuff pressure required to occlude arterial flow. Wide BFR cuffs restrict arterial blood flow at a lower pressure than narrow BFR cuffs, suggesting that future studies account for the width of the cuff used. In addition, we have outlined models which indicate that restrictive cuff pressures should be largely based on thigh circumference and not on pressures previously used in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • ACSM (2009) American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Med Sci Sports Exerc 41(3):687–708

    Article  Google Scholar 

  • Cook SB, Clark BC, Ploutz-Snyder LL (2007) Effects of exercise load and blood-flow restriction on skeletal muscle function. Med Sci Sports Exerc 39(10):1708–1713

    Article  PubMed  Google Scholar 

  • Crenshaw AG, Hargens AR, Gershuni DH, Rydevik B (1988) Wide tourniquet cuffs more effective at lower inflation pressures. Acta Orthop Scand 59(4):447–451

    Article  PubMed  CAS  Google Scholar 

  • Fahs CA, Rossow LM, Seo DI, Loenneke JP, Sherk VD, Kim E, Bemben DA, Bemben MG (2011) Effect of different types of resistance exercise on arterial compliance and calf blood flow. Eur J Appl Physiol. doi:10.1007/s00421-011-1927-y

  • Iida H, Kurano M, Takano H, Kubota N, Morita T, Meguro K, Sato Y, Abe T, Yamazaki Y, Uno K, Takenaka K, Hirose K, Nakajima T (2007) Hemodynamic and neurohumoral responses to the restriction of femoral blood flow by KAATSU in healthy subjects. Eur J Appl Physiol 100(3):275–285

    Article  PubMed  Google Scholar 

  • Inagaki Y, Madarame H, Neya M, Ishii N (2011) Increase in serum growth hormone induced by electrical stimulation of muscle combined with blood flow restriction. Eur J Appl Physiol. doi:10.1007/s00421-011-1899-y

  • Kacin A, Strazar K (2011) Frequent low-load ischemic resistance exercise to failure enhances muscle oxygen delivery and endurance capacity. Scand J Med Sci Sports. doi:10.1111/j.1600-0838.2010.01260.x

  • Karabulut M, Bemben DA, Sherk VD, Anderson MA, Abe T, Bemben MG (2011a) Effects of high-intensity resistance training and low-intensity resistance training with vascular restriction on bone markers in older men. Eur J Appl Physiol 111(8):1659–1667

    Article  PubMed  Google Scholar 

  • Karabulut M, McCarron J, Abe T, Sato Y, Bemben M (2011b) The effects of different initial restrictive pressures used to reduce blood flow and thigh composition on tissue oxygenation of the quadriceps. J Sports Sci 29(9):951–958

    Article  PubMed  Google Scholar 

  • Kubota A, Sakuraba K, Sawaki K, Sumide T, Tamura Y (2008) Prevention of disuse muscular weakness by restriction of blood flow. Med Sci Sports Exerc 40(3):529–534

    Article  PubMed  Google Scholar 

  • Kubota A, Sakuraba K, Koh S, Ogura Y, Tamura Y (2011) Blood flow restriction by low compressive force prevents disuse muscular weakness. J Sci Med Sport 14(2):95–99

    Article  PubMed  Google Scholar 

  • Laurentino G, Ugrinowitsch C, Aihara AY, Fernandes AR, Parcell AC, Ricard M, Tricoli V (2008) Effects of strength training and vascular occlusion. Int J Sports Med 29(8):664–667

    Article  PubMed  CAS  Google Scholar 

  • Laurentino G, Ugrinowitsch C, Roschel H, Aoki MS, Soares AG, Neves M, Aihara AY, da Rocha Correa Fernandes A, Tricoli V (2011) Strength training with blood flow restriction diminishes myostatin gene expression. Med Sci Sports Exerc. doi: 10.1249/MSS.0b013e318233b4bc

  • Loenneke JP, Pujol TJ (2009) The use of occlusion training to produce muscle hypertrophy. Strength Cond J 31(3):77–84

    Article  Google Scholar 

  • Loenneke JP, Pujol TJ (2011) Sarcopenia: an emphasis on occlusion training and dietary protein. Hippokratia 15(2):132–137

    PubMed  CAS  Google Scholar 

  • Loenneke JP, Kearney ML, Thrower AD, Collins S, Pujol TJ (2010a) The acute response of practical occlusion in the knee extensors. J Strength Cond Res 24(10):2831–2834

    Article  PubMed  Google Scholar 

  • Loenneke JP, Wilson GJ, Wilson JM (2010b) A mechanistic approach to blood flow occlusion. Int J Sports Med 31(1):1–4

    Article  PubMed  CAS  Google Scholar 

  • Loenneke JP, Balapur A, Thrower AD, Barnes JT, Pujol TJ (2011a) Blood flow restriction reduces time to muscular failure. Eur J of Sport Sci. doi:10.1080/17461391.2010.551420

  • Loenneke JP, Balapur A, Thrower AD, Barnes JT, Pujol TJ (2011b) The perceptual responses to occluded exercise. Int J Sports Med 32(3):181–184

    Article  PubMed  CAS  Google Scholar 

  • Loenneke JP, Fahs CA, Wilson JM, Bemben MG (2011c) Blood flow restriction: the metabolite/volume threshold theory. Med Hypotheses 77(5):748–752

    Article  PubMed  CAS  Google Scholar 

  • Loenneke JP, Thrower AD, Balapur A, Barnes JT, Pujol TJ (2011d) The energy requirement of walking with restricted blood flow. Acta Kinesiologica (In press)

  • Loenneke JP, Wilson JM, Wilson GJ, Pujol TJ, Bemben MG (2011e) Potential safety issues with blood flow restriction training. Scand J Med Sci Sports 21(4):510–518

    Article  PubMed  CAS  Google Scholar 

  • Loenneke JP, Thrower AD, Balapur A, Barnes JT, Pujol TJ (2011f) Blood flow–restricted walking does not result in an accumulation of metabolites. Clin Physiol Funct Imaging. doi:10.1111/j.1475-097X.2011.01059.x

  • Manini TM, Vincent KR, Leeuwenburgh CL, Lees HA, Kavazis AN, Borst SE, Clark BC (2011) Myogenic and proteolytic mRNA expression following blood flow restricted exercise. Acta Physiol (Oxf) 201(2):255–263

    Article  CAS  Google Scholar 

  • O’Brien RM (2007) A caution regarding rules of thumb for variance inflation factors. Qual Quant 41:673–690

    Article  Google Scholar 

  • Patterson SD, Ferguson RA (2011) Enhancing strength and postocclusive calf blood flow in older people with training with blood-flow restriction. J Aging Phys Act 19(3):201–213

    PubMed  Google Scholar 

  • Rossow L, Fahs CA, Sherk VD, Seo D, Bemben DA, Bemben MG (2011) The effect of acute blood-flow-restricted resistance exercise on postexercise blood pressure. Clin Physiol Funct Imaging 31(6):429–434

    Article  PubMed  Google Scholar 

  • Sakamaki M, Bemben MG, Abe T (2011) Legs and trunk muscle hypertrophy following walk training with restricted leg muscle blood flow. J Sports Sci Med 10:338–340

    Google Scholar 

  • Shaw JA, Murray DG (1982) The relationship between tourniquet pressure and underlying soft-tissue pressure in the thigh. J Bone Joint Surg Am 64(8):1148–1152

    PubMed  CAS  Google Scholar 

  • Sugaya M, Yasuda T, Suga T, Okita K, Abe T (2011) Change in intramuscular inorganic phosphate during multiple sets of blood flow-restricted low-intensity exercise. Clin Physiol Funct Imaging 31(5):411–413

    Article  PubMed  Google Scholar 

  • Takada S, Okita K, Suga T, Omokawa M, Morita N, Horiuchi M, Kadoguchi T, Takahashi M, Hirabayashi K, Yokota T, Kinugawa S, Tsutsui H (2011) Blood Flow Restriction Exercise in Sprinters and Endurance Runners. Med Sci Sports Exerc. doi:10.1249/MSS.0b013e31822f39b3

  • Teramoto M, Golding LA (2006) Low-intensity exercise, vascular occlusion, and muscular adaptations. Res Sports Med 14(4):259–271

    PubMed  Google Scholar 

  • Wernbom M, Augustsson J, Thomee R (2006) Effects of vascular occlusion on muscular endurance in dynamic knee extension exercise at different submaximal loads. J Strength Cond Res 20(2):372–377

    PubMed  Google Scholar 

  • Wernbom M, Jarrebring R, Andreasson MA, Augustsson J (2009) Acute effects of blood flow restriction on muscle activity and endurance during fatiguing dynamic knee extensions at low load. J Strength Cond Res 23(8):2389–2395

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None of the authors report a conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeremy P. Loenneke.

Additional information

Communicated by Keith Phillip George.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Loenneke, J.P., Fahs, C.A., Rossow, L.M. et al. Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise. Eur J Appl Physiol 112, 2903–2912 (2012). https://doi.org/10.1007/s00421-011-2266-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00421-011-2266-8

Keywords

Navigation