ORIGINAL RESEARCH article
Front. Sports Act. Living
Sec. Exercise Physiology
Volume 7 - 2025 | doi: 10.3389/fspor.2025.1654522
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 20 articles
A comparison of blood flow restriction devices to assess limb occlusion pressure in supine and standing positions
Provisionally accepted
Tulasiram Bommasamudram1
Kirtana Nayak2*
Matthew J Clarkson3
Rajagopal Kadavigere4
Aaron Paul Russell5
Stuart Warmington5*- 1Department of Exercise and Sports Science, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- 2Department of Physiology, Kasturba Medical College Manipal, Manipal, India
- 3Victoria University Institute for Health and Sport, Melbourne, Australia
- 4Department of Radiodiagnosis and Imaging, Kasturba Medical College Manipal, Manipal, India
- 5Deakin University Institute for Physical Activity and Nutrition, Burwood, Australia
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Objective: The objective of this study was to compare five commercially available blood flow restriction (BFR) devices in determining limb occlusion pressure (LOP), plus two algorithm approaches for determining LOP, in both supine and standing positions. Methods: Twenty-one recreationally active males were assessed for LOP using five BFR devices: Zimmer (surgical-grade tourniquet; reference standard), AirBands, blood pressure cuff with pulse oximeter (BPPO), Smart Cuffs, and Suji. Two additional algorithms based on resting anthropometric/physiological data were also assessed. LOP was measured in both supine and standing positions, with two measurements per posture separated by a five-minute interval. In addition to LOP, participants rated their level of discomfort during each measurement. Results: When compared to the Zimmer device, BPPO (r = 0.636, p = 0.002) and Smart Cuffs (r = 0.758, p < 0.001) demonstrated the closest association in the supine and standing positions, respectively. AirBands exhibited the greatest deviation from Zimmer in both positions but were consistently rated as more comfortable (p > 0.05), even at higher pressures. Conclusion: None of the devices showed consistent LOP measurements across both postures, indicating significant variability depending on device type and body position. These findings underscore the need for posture-specific calibration when using BFR devices and caution against assuming device interchangeability. Keywords: blood flow restriction; limb occlusion pressure, kaatsu; arterial occlusion pressure; occlusion.
Keywords: Blood flow restriction, Limb occlusion pressure, kaatsu, Arterial occlusion pressure, occlusion
Received: 26 Jun 2025; Accepted: 16 Oct 2025.
Copyright: © 2025 Bommasamudram, Nayak, Clarkson, Kadavigere, Russell and Warmington. 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:
Kirtana Nayak, kirtana.pai@manipal.edu
Stuart Warmington, stuart.warmington@deakin.edu.au
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.