ORIGINAL RESEARCH article
Front. Physiol.
Sec. Exercise Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1658744
This article is part of the Research TopicImpact of Blood Flow Restriction Device Features and Methodological Considerations on Acute- and Longitudinal Responses to Blood Flow Restricted ExerciseView all 18 articles
Predictors of Lower-Limb Arterial Occlusion Pressure Across Commonly Used Cuff Widths
Provisionally accepted
- 1Northern Michigan University, Marquette, United States
- 2Michigan Technological University, Houghton, United States
- 3Purdue University Northwest, Hammond, United States
- 4Kent State University, Kent, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
We compared predictors of lower-limb arterial occlusion pressure (AOP) across commonly used blood flow restriction (BFR) cuff widths (11, 13, 18cm) and developed prediction equations to estimate AOP for each cuff. Participants (n=116) underwent measurements of thigh circumference (TC), systolic (SBP) and diastolic (DBP) blood pressure, and AOP was assessed using Doppler ultrasound in a seated position. Multiple linear regression models with commonality analysis and mixed-effects models were used to identify and compare predictors of AOP between each cuff. LASSO regression with bootstrap resampling was used to develop and internally validate prediction equations. TC, SBP, DBP, age, and sex explained 60-70% of total variance in AOP, with greater predictive power in narrower cuffs. As cuff width increased, TC uniquely accounted for less (36%, 26%, 11% for 11, 13, 18cm, respectively) and SBP uniquely accounted for more (2%, 6%, 12% for 11, 13, 18cm, respectively) variance. A cuff width × TC interaction indicated that limb size had greater influence on AOP with narrower cuffs. In contrast, the relationship between SBP and AOP remained stable across cuff widths. Prediction equations demonstrated good predictability and calibration, with limits of agreement ranging from ±18.4 to ±28.6 mmHg and statistical equivalence between predicted and measured AOP. Internal validation showed minimal overfitting. These findings highlight the importance of accounting for cuff width in BFR pressure prescription, with narrower cuffs requiring consideration primarily of TC, and wider cuffs requiring consideration of both TC and SBP. These cuff-specific equations may offer a practical alternative to direct AOP measurement.
Keywords: Blood flow restriction, vascular occlusion, kaatsu, systolic blood pressure, Limb Occlussion Pressure
Received: 03 Jul 2025; Accepted: 24 Sep 2025.
Copyright: © 2025 Wedig, Lennox, Petushek, Durocher, McDaniel and Elmer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Steven Elmer, sjelmer671@stkate.edu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.