An investigation into setting the blood flow restriction pressure based on perception of tightness

Objective: To determine whether the perceived tightness scale could be used to set sub-occlusive blood flow restriction pressures. A secondary aim was to determine variables that may impact individual ratings. Approach: One hundred and twenty participants completed three separate conditions in one limb within the upper and lower body. Participants were asked to rate their perceived tightness for two of the three conditions, regarded as moderate pressure without pain (7/10) and intense pressure with pain (10/10).A third condition, arterial occlusion pressure, was completed that required no rating from participants. Order of conditions and limb assignment were randomized for each participant. Measurements for muscle and fat thickness along with limb circumference were completed on the tested limbs. Main results: Order of conditions did not affect results in the upper or lower body. A condition effect was found for the upper body with the 7/10 rating lower than the arterial occlusion pressure [7/10: 132 (38) mmHg < Arterial Occlusion: 162 (24) mmHg < 10/10: 202 (46) mmHg]. A condition effect was also found for the lower body with 7/10 condition [120 (33) mmHg] rating lower than arterial occlusion pressure [171 (28) mmHg] and 10/10 condition [178 (49) mmHg]. However, there was a non-significant difference between the arterial occlusion pressure and the 10/10 condition (difference of 7 ( -3, 18) mmHg, (P = 0.159). Significance: Participants appear adept in their ability to rate subocclusive pressure based upon perceived tightness. Findings from this study provide some support for the utility of this method as a means for completion of practical blood flow restriction, whereby individuals tighten the cuff based upon their relative perceptual response.