Influence and reliability of lower-limb arterial occlusion pressure at different body positions

Background: Total arterial occlusive pressure (AOP) is used to prescribe pressures for surgery, blood flow restriction (BFRE) and ischemic preconditioning (IPC). AOP is often measured in a supine position; however, the influence of body position on AOP measurement is unknown and may influence of the level of occlusion in different positions during BFR and IPC. The aim of this study was therefore to investigate the influence of body position on AOP. Methods: Fifty healthy individuals (age = 29 ± 6 y) underwent AOP measurements on the dominant lower-limb in supine, seated and standing positions in a randomised order. AOP was measured automatically using an automated pneumatic tourniquet system, with each measurement separated by 5 minutes of rest. Results: AOP was significantly lower in the supine position compared to the seated position (187.00 ± 32.5 vs 204.00 ± 28.5 mmHg, p<0.001) and standing position (187.00 ± 32.5 vs. 241.50 ± 49.3 mmHg, p<0.001). AOP was significantly higher in the standing position compared to the seated position (241.50 ± 49.3 vs. 204.00 ± 28.5 mmHg, p<0.001). Discussion: AOP measurement is body position dependent, thus for accurate prescription of occlusion pressure during surgery, BFR and IPC, AOP should be measured in the position intended for subsequent application of occlusion.