Reproducibility of Doppler Ultrasound in Finding Limb Occlusion Pressure with Blood Flow Restriction (BFR) Training | Modern Manual Therapy Blog

Reproducibility of Doppler Ultrasound in Finding Limb Occlusion Pressure with Blood Flow Restriction (BFR) Training



In physical therapy, and in truth any healthcare field, it is important to identify measurement instruments that have high reproducibility; that is to say the data obtain from said instrument can be reliably reproduced with subsequent measurements; and use them in clinical practice.

Despite its widespread use, the reproducibility of Doppler Ultrasound (DUS) results measuring limb occlusion pressure (LOP) for BFR had not been yet been researched until a study by Bezzera de Moralis, et al. was released in 2016 entitled: "Upper limbs total occlusion pressure assessment: Doppler ultrasound reproducibility and determination of predictive variables." In it, the authors concluded that DUS has "good reproducibility".

The news that the use of Doppler Ultrasound has good reproducibility in identifying limb occlusion pressure (LOP) is good news for those of us who use it for blood flow restriction (BFR) training. As part of my continuing education course, The Eclectic Approach: Modern Strength Training, I spend a considerable amount of time educating clinicians and strength coaches that while we want to find LOP to individualize pressures, LOP can change on a number of factors: limb girth, location and width of the BFR band, hydration, time of day, etc. It is nice to see that given the variability in the measurement, Doppler US still holds water as the gold standard.

Of note - while this study exclusively looked at reproducibility in the upper extremity, it is safe to assume that the reproducibility would be similar in the lower extremity. However, further studies are needed to confirm.

The ultimate take home message: score one for the use of Doppler US with BFR training. Continue to use to provide safe and effective BFR training options to your clients and patients!

Kyle Coffey
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Keeping it Eclectic...

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