Measuring Arterial Occlusion Pressure Using Pulse Wave and Continuous Wave Doppler Ultrasound and 2 Methods of Cuff Inflation.

CONTEXT

It is recommended that arterial occlusion pressure (AOP) should be measured prior to the use of blood flow restriction training. Previous studies have not compared measures of AOP when using 2 methods of cuff inflation commonly reported in the literature.

DESIGN

A cross-sectional observational study was used to compare the measurement of brachial artery AOP as measured using pulse wave Doppler ultrasound (PWDOP) and continuous wave Doppler ultrasound (CWDOP) devices when inflating the cuff with a research/clinical-grade Hokanson (HOK) rapid cuff inflation system and manually (MAN) with a hand pump and gauge.

METHODS

We made simultaneous measures of brachial artery AOP in 20 males and 21 females using PWDOP and CWDOP devices when using HOK and MAN cuff inflation methods. Data were analyzed with a linear mixed model analysis of variance and Bland-Altman plots.

RESULTS

There was not a significant main effect for the overall differences in AOP as measured using PWDOP (121.7 ± 14.7 mmHg) and CWDOP (121.3 ± 14.5 mmHg; P = .3641). There was a significant overall main effect for AOP measured using the HOK (122.7 ± 14.6 mmHg) and MAN (120.3 ± 14.6 mmHg) cuff inflation methods (P < .0001) and between males (128.2 ± 13.7 mmHg) and females (115.2 ± 12.5 mmHg; P = .0034). Bland-Altman plots revealed minimal bias and reasonable limits of agreement between PWDOP and CWDOP measures of AOP when using HOK (0.8 mmHg; 95% CI, -4.7 to 3.0 mmHg) and MAN (0.4 mmHg; 95% CI, -5.3 to 4.5 mmHg) cuff inflation methods.

CONCLUSIONS

The cessation of an audible pulse using CWDOP is in agreement with the complete obstruction of the arterial blood flow observed using PWDOP. Although statistically significant, small differences in PWDOP and CWDOP measures of AOP when using HOK and MAN cuff inflation methods are of little practical significance. A hand-held CWDOP device and a handpump/gauge can be used to measure AOP.