Differences in the limb blood flow between two types of blood flow restriction cuffs: A pilot study

Abstract

Introduction: The determination of the optimal occlusion level is a key parameter in blood flow restriction (BFR). This study aimed to compare the effects of elastic (BStrong) vs. nylon (Hokanson) BFR cuffs on blood flow in the lower and upper limbs.Methods: Eleven healthy participants undertook several BFR sessions with 2 different cuffs of similar width on their lower and upper limbs at different pressures [200, 250, 300, 350, and 400 mmHg for BStrong and 0, 40, and 60% of the arterial occlusion pressure (AOP) for Hokanson]. Doppler ultrasound recorded blood flows through the brachial and femoral artery at rest.Results: With BStrong, only 350 and 400 mmHg pressures were significantly different from resting values (0% AOP). With Hokanson, both 40% and 60% of the AOP were significantly different from resting values (p < 0.05).Discussion: While both cuffs elicited BFR, they failed to accurately modulate blood flow. Hokanson is appropriate for research settings while BStrong appears to be a convenient tool for practitioners due to its safety (i.e., the impossibility of completely occluding arteries) and the possibility of exercising freely detached from the pump.

Beneath the cuff: Often overlooked and under-reported blood flow restriction device features and their potential impact on practice—A review of the current state of the research

“…However, without considering the impact of each cuff on occlusive capabilities and subsequent fatigue accumulation during exercise, extrapolating effectiveness should be done with caution. As accelerated muscle fatigue is likely the primary way BFR induces its beneficial effect on muscle (Jessee et al, 2018), the design of Bordessa et al (Bordessa et al, 2021) gives limited guidance to the potential efficacy of the B-Strong ™ cuff bladder system compared to the Delfi Personalized The most recent study published in late 2022 compared the B-Strong ™ cuff to the Hokanson research tourniquet on capacity to modulate resting limb blood flow in the upper and lower limbs (Citherlet et al, 2022). Eleven healthy participants (n = 7 females) had all their extremities assessed with both cuffs and their resting blood flow monitored following application of different pressures (e.g., 40%-60% AOP with Hokanson and 200-400 mmHg pressures with B-Strong ™ ).…”

“…Recently, commercially available devices have entered the marketplace that consist of numerous sequential bladders that according to the manufacturer (B-Strong™ Bands (B-Strong Training Systems™, Park City, UT, United States); B3 BFR Bands (B3 Sciences, Frisco, TX, United States) are designed to reduce the potential for arterial occlusion and may result in a non-uniform circumferential pressure during exercise ( Figure 1 ) ( Early et al, 2020 ). As the multi-chambered bladder system is not designed to occlude, measurement of AOP is largely unfeasible in most individuals ( Citherlet et al, 2022 ), so the manufacturer recommends pressures of 250 mmHg for the upper body and 350 mmHg for the lower body ( Early et al, 2020 ) or a pressure based on individual factors using an app ( Bordessa et al, 2021 ; Callanan et al, 2022 ). These cuff systems do appear to induce additional acute physiological stress over work-matched free flow exercise ( Stray-Gundersen et al, 2020 ; Wooten et al, 2020 ), indicating that they have the potential to produce beneficial adaptations in a longitudinal training approach.…”

“…Within the current BFR body of literature, there are three published studies that compared the acute responses of a multi-chambered bladder system to a single-bladder system ( Stray-Gundersen et al, 2020 ; Bordessa et al, 2021 ; Citherlet et al, 2022 ) and four studies on multi-chambered bladder systems compared to a free-flow control ( Wooten et al, 2020 ; Wilburn et al, 2021 ; Callanan et al, 2022 ; Machek et al, 2022 ) ( Table 1 ). For completion’s sake, we have displayed the four additional multi-chambered bladder investigations that compared responses to free-flow exercise to highlight the limited overall body of research in this area ( Table 1 ).…”

“…Only two ( Bordessa et al, 2021 ; Citherlet et al, 2022 ) of the three comparison studies set pressures in the single-chambered system relative to %AOP in the comparison condition, whereas the other study ( Stray-Gundersen et al, 2020 ) assigned an arbitrary pressure. Despite the limitation mentioned, all three studies provide important context to the discussion of the potential impact of bladder design on the BFR stimulus.…”

PROFILES: portrait-type de nos futurs médecins !

“…7 Pour des considérations plus pratiques, l'utilisation de brassards élastiques pourrait être recommandée dans la rééducation en raison de sa sécurité (pas d'occlusion artérielle complète). 8 Il semble que toute différence de matériau pourrait être corrigée en appliquant simplement une pression définie par rapport à la POA cible.…”