Blood flow restriction training prescription: Analysis of Alternative Methods for Estimating Arterial Occlusion Pressure Percentages

Background Blood flow restriction (BFR) exercise is recommended with personalized pressures between 40% and 80% of arterial occlusion pressure (AOP) to ensure safety and efficacy. However, many studies use fixed pressures or personalized pressures based on brachial blood pressure, such as 130% of resting brachial systolic pressure (SBP), which may lead to inconsistencies. This study aimed to estimate the percentage of AOP in the thigh when using fixed pressures (e.g., 100, 200, and 300 mmHg) or 130% of SBP. Methods Fifty-one healthy participants (18–40 years) underwent anthropometric measurements, brachial blood pressure assessment, and AOP determination in the thigh in supine, seated, and standing positions using an 18 cm cuff. AOP measurements were randomized and compared to fixed pressures and 130% of SBP. Results AOP was significantly higher than 100 mmHg in all positions (p < 0.001), with 100 mmHg corresponding to 80.5%, 62%, and 56.9% of AOP in the supine, seated, and standing positions, respectively. Conversely, 200 mmHg significantly exceeded AOP (p < 0.001), reaching 160.9%, 124.2%, and 113.7% in the same positions. Compared to SBP, supine AOP was lower than 130% of SBP (p < 0.001), standing AOP was higher, and seated AOP showed no significant difference (p = 0.595). In the seated and standing positions, 130% of SBP corresponded to 92.5% and 84.7% of AOP, respectively. Conclusion Fixed pressures may fall within the recommended range for BFR prescription, but findings are specific to AOP assessment with an 18 cm cuff. Personalization remains crucial for accuracy and safety.