How to use BFR?
Despite the observed benefits of this unique exercise method, a standardised protocol is yet to be established. For example, a wide range of devices have been used to restrict blood flow, including nylon pneumatic cuffs (24,25), traditional blood pressure cuffs (26,27), elastic belts with a pneumatic bag inside (28,29), and elastic knee wraps (30-33). The use of elastic wraps for BFR was first proposed by Leonneke and Pujol (30) and is often referred to as ‘practical BFR’ because it circumvents the need for expensive equipment, improving accessibility and usability. This method has since been demonstrated to provide a safe, effective and ecologically valid occlusive stimulus for BFR training.
A wide range of restrictive cuff pressures have also been documented in the research, including the use of a standardised limb occlusion pressure (LOP) across participants, pressure relative to the patient’s systolic blood pressure, and pressure relative to the patient’s limb circumference. These methods are however only available to those with suitable equipment which led to the adoption of a more practical means of applying pressure (i.e. wraps) through using a perceived measure of tightness (30-32,34,35). Previous research found that sufficient occlusive pressures can be applied when participants rated the level of tightness from the cuff as a 7 out of 10, indicating that a perceived scale of tightness can be a viable method for determining an appropriate level of cuff restriction (34).