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      A Practical Approach for Ischemic Preconditioning Intervention in Sports: A Pilot Study for Cuff Thigh Occlusion Pressure Estimation Based on Systolic Blood Pressure

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          Abstract

          For the ischemic preconditioning (IPC) intervention, the accuracy of the protocol is paramount for mediating its possible ergogenic effects. However, the lack of standardization and widespread use of arbitrary cuff pressures (ranging from 130 to >300 mmHg) have been predominantly observed, potentially affecting the results and compromising the reproducibility of findings. Thus, the purpose of this study was to determine an appropriate cuff pressure during IPC. Seventeen healthy male participants were enrolled in the study. Anthropometric measurements were initially conducted, followed by systolic and diastolic blood pressure measurements. Subsequently, we determined the individual thigh occlusion pressure (TOP) for the right leg using a hand-held Doppler device. Based on these findings, we developed an estimation equation for TOP, considering the current brachial systolic blood pressure (SBP) values. We then conducted a retrospective analysis of its capacity to mediate occlusion. We observed the ability to estimate TOP using the equation (p = 0.01; ES: 0.86), presenting ~6% superiority in absolute values for occlusion compared to direct measurement (TOP equation: 169.9 ± 9.1; TOP direct measured: 161.2 ± 11.1). However, TOP estimation was insufficient to produce complete occlusion in two out of 17 subjects (11.8%). In conclusion, the estimation of TOP incorporating SBP values may offer a valid and practical means for cuff administration during IPC protocols with potential to minimize adverse effects and maximize its positive effects.

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          Most cited references26

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          Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis.

          Low-load exercise training with blood flow restriction (BFR) can increase muscle strength and may offer an effective clinical musculoskeletal (MSK) rehabilitation tool. The aim of this review was to systematically analyse the evidence regarding the effectiveness of this novel training modality in clinical MSK rehabilitation.
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              Effects of cuff width on arterial occlusion: implications for blood flow restricted exercise.

              The purpose of this study was to determine the difference in cuff pressure which occludes arterial blood flow for two different types of cuffs which are commonly used in blood flow restriction (BFR) research. Another purpose of the study was to determine what factors (i.e., leg size, blood pressure, and limb composition) should be accounted for when prescribing the restriction cuff pressure for this technique. One hundred and sixteen (53 males, 63 females) subjects visited the laboratory for one session of testing. Mid-thigh muscle (mCSA) and fat (fCSA) cross-sectional area of the right thigh were assessed using peripheral quantitative computed tomography. Following the mid-thigh scan, measurements of leg circumference, ankle brachial index, and brachial blood pressure were obtained. Finally, in a randomized order, arterial occlusion pressure was determined using both narrow and wide restriction cuffs applied to the most proximal portion of each leg. Significant differences were observed between cuff type and arterial occlusion (narrow: 235 (42) mmHg vs. wide: 144 (17) mmHg; p = 0.001, Cohen's D = 2.52). Thigh circumference or mCSA/fCSA with ankle blood pressure, and diastolic blood pressure, explained the most variance in the cuff pressure required to occlude arterial flow. Wide BFR cuffs restrict arterial blood flow at a lower pressure than narrow BFR cuffs, suggesting that future studies account for the width of the cuff used. In addition, we have outlined models which indicate that restrictive cuff pressures should be largely based on thigh circumference and not on pressures previously used in the literature.
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                Author and article information

                Journal
                J Hum Kinet
                J Hum Kinet
                JHK
                Journal of Human Kinetics
                Termedia Publishing House
                1640-5544
                1899-7562
                15 April 2024
                March 2024
                : 91
                : Spec Issue
                : 157-164
                Affiliations
                [1 ]Department of Biophysics and Physiology, Exercise Physiology Performance—EXPPER, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
                [2 ]Centre for Applied Performance Science, St. Mary’s University, London, United Kingdom.
                [3 ]Department of Anatomy, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
                Author notes
                [* ]Correspondence: isamjf@ 123456gmail.com
                Article
                186064
                10.5114/jhk/186064
                11057619
                38689581
                24945d08-cc00-4e68-b7b8-8e0fb1347c92
                Copyright: © Academy of Physical Education in Katowice

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) ( https://creativecommons.org/licenses/by/4.0/). This license lets others distribute, remix, adapt, and build upon your work, even commercially, as long as they credit you for the original creation.

                History
                : 13 February 2024
                : 14 March 2024
                Categories
                Research Paper

                ischemia,reperfusion,arterial pressure,tourniquet
                ischemia, reperfusion, arterial pressure, tourniquet

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