Gargallo-Bayo P, Rodrigo-Mallorca D, Calatayud J, Suso-Martí L, Vicent-Micó J, Chulvi-Medrano I. Examining the impact of blood flow restriction on cardiac rehabilitation outcomes. World J Cardiol 2025; 17(12): 111591 [DOI: 10.4330/wjc.v17.i12.111591]
Corresponding Author of This Article
Iván Chulvi-Medrano, PhD, Senior Researcher, Research Group on Prevention and Health in Exercise and Sport, Department of Physical and Sports Education, University of Valencia, C/Gascó Oliag 3, Valencia 46010, Spain. ivan.chulvi@uv.es
Research Domain of This Article
Sport Sciences
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Pedro Gargallo-Bayo, Joaquin Calatayud, Luis Suso-Martí, Exercise Intervention for Health Research Group, Department of Physiotherapy, University of Valencia, Valencia 46010, Spain
Darío Rodrigo-Mallorca, Department of Physical and Sports Education, University of Valencia, Valencia 46010, Spain
Jordi Vicent-Micó, Department of Physiotherapy, University of Valencia, Valencia 46010, Spain
Iván Chulvi-Medrano, Research Group on Prevention and Health in Exercise and Sport, Department of Physical and Sports Education, University of Valencia, Valencia 46010, Spain
Author contributions: Gargallo-Bayo P and Chulvi-Medrano I contributed to conceptualization, methodology (review design and protocol), project administration; Rodrigo-Mallorca D and Vicent-Micó J contributed to search strategy and study selection, synthesis of results; Gargallo-Bayo P, Vicent-Micó J and Chulvi-Medrano I contributed to writing-original draft, visualization; Rodrigo-Mallorca D, Calatayud J and Suso-Martí L contributed to writing-review and editing; all authors contributed to critical revision of the manuscript for important intellectual content; all authors read and gave final approval of the final version to be published.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to the content of this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Iván Chulvi-Medrano, PhD, Senior Researcher, Research Group on Prevention and Health in Exercise and Sport, Department of Physical and Sports Education, University of Valencia, C/Gascó Oliag 3, Valencia 46010, Spain. ivan.chulvi@uv.es
Received: July 4, 2025 Revised: July 30, 2025 Accepted: November 7, 2025 Published online: December 26, 2025 Processing time: 174 Days and 0.8 Hours
Abstract
Physical exercise is a cornerstone of cardiac rehabilitation, with resistance training increasingly recognized as essential due to the "muscular hypothesis" in cardiac-related frailty. However, many patients are unable to achieve the required training intensities to gain the associated benefits, highlighting the need for alternative approaches. Blood flow restriction (BFR) training has recently emerged as a promising strategy for this population. This qualitative mini-review explores the acute effects and long-term adaptations of BFR training in patients undergoing cardiac rehabilitation, aiming to provide insights into its potential as a viable and effective intervention in health-related outcomes.
Core Tip: Blood flow restriction (BFR) training appears to be a safe and effective strategy to enhance muscle strength, functional capacity, and cardiorespiratory fitness in individuals with cardiovascular disease (CVD). Typically performed with low loads (10%-40% one-repetition maximum), continuous occlusion, and a frequency of 2-3 sessions per week, BFR has shown high adherence and favorable outcomes without serious adverse events. However, cautious implementation is essential in patients with advanced or unstable conditions. When applied under clinical supervision, BFR represents a promising adjunct to traditional cardiac rehabilitation programs, expanding therapeutic possibilities in CVD.
Citation: Gargallo-Bayo P, Rodrigo-Mallorca D, Calatayud J, Suso-Martí L, Vicent-Micó J, Chulvi-Medrano I. Examining the impact of blood flow restriction on cardiac rehabilitation outcomes. World J Cardiol 2025; 17(12): 111591
Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide and represent a critical public health priority. According to the World Health Organization, approximately 17.9 million individuals die each year from CVD-related causes, accounting for around 32% of all global deaths-85% of which are attributable to myocardial infarction and cerebrovascular accidents, many of which could be prevented through effective management of modifiable risk factors such as hypertension, physical inactivity, obesity, and tobacco use[1].
In Europe, CVDs also remain a leading cause of mortality. Eurostat reports that in 2022 diseases of the circulatory system accounted for 32.7% of all deaths in the European Union, with ischemic heart diseases and cerebrovascular diseases as the primary contributors. These conditions caused approximately 1.7 million deaths annually, highlighting their significant public health impact. Notably, in most European Union countries, the share of deaths due to circulatory diseases is higher among women than men, with only a few countries reporting slightly higher mortality rates in men[2].
Owing to advances in prevention strategies and, most notably, improvements in treatment, global mortality from CVDs has decreased by 34.9% between 1990 and 2022[3]. This decline in mortality has led to increased survival rates, highlighting the need for comprehensive therapeutic approaches aimed at improving not only cardiovascular health but also overall well-being. One such intervention is known as cardiac rehabilitation[4].
Physical exercise is a cornerstone of cardiac rehabilitation and plays a central role in the secondary prevention of CVDs[5]. In recent years, resistance training has gained prominence as a key component of secondary prevention in individuals with cardiac conditions. This growing interest has been framed by some experts as the “muscle hypothesis” in the context of heart failure and cardiac rehabilitation[6]. This hypothesis proposes that impaired exercise capacity in heart failure patients stems primarily from two interrelated and pathological skeletal muscle conditions: (1) Structural muscle atrophy; and (2) Metabolic dysfunction[7]. These alterations initiate a self-perpetuating pathological cascade characterized by early onset of dyspnea and fatigue, exaggerated ventilatory response, sympathetic nervous system overactivation, hemodynamic deterioration and progressive catabolism[8]. This multilevel pathophysiology collectively exacerbates both cardiac function and musculoskeletal performance in a deleterious feedback loop. The rationale behind this approach lies primarily in the need to prevent frailty, which may result from the disease itself, surgical interventions, or prolonged physical inactivity. Such disuse often leads to sarcopenia, which in turn negatively affects exercise tolerance[9].
Current resistance training guidelines recommend moderate [50%–70% of one-repetition maximum (1RM)] to high intensities (70%–85% 1RM) to promote meaningful morpho-functional adaptations in the musculoskeletal system[10]. However, such intensities may not be advisable for many cardiac patients, thereby necessitating the exploration of alternative exercise modalities. In fact, in cardiac rehabilitation, according to clinical guidelines and position stands on exercise prescription for patients with cardiac conditions, it is recommended to start with intensities at or below 30% of 1RM (rate of perceived exertion 11–12) and progressively increase the load to 40%–70% (rate of perceived exertion 12–15) for the upper body, and 40%–80% of 1RM for the lower body, with 12–15 repetitions per set, multiplied by 2–3 sets per muscle group[5,11,12].
In this context, blood flow restriction (BFR) training has emerged as a promising methodology that combines low- to moderate-intensity resistance or aerobic exercise with the application of external pressure via a cuff placed on the proximal portion of the limb being trained. This cuff is inflated to a pressure that partially restricts venous return while maintaining arterial inflow, thereby creating a localized hypoxic environment[13]. Multiple studies have confirmed the safety of this training modality[14-16]. Moreover, its efficacy in eliciting structural[17] and functional[18] adaptations comparable to those achieved with high-intensity training has prompted growing interest in its application within clinical populations[19,20], particularly in individuals with musculoskeletal impairments[21]. Effectiveness has even been reported when BFR is applied without exercise prior to a subsequent exercise (ischemic preconditioning), suggesting that incorporating BFR prior to endurance exercise represents an effective intervention strategy for enhancing functional capacity and quality of life in sedentary older populations[22].
When preceded by appropriate screening procedures to exclude individuals for whom BFR training may pose a risk[13,16,23], and when administered under the supervision of qualified professionals adhering to established training protocols, low-intensity resistance training with BFR can be considered safe.
Given this rationale, the use of BFR training is increasingly being explored in populations with cardiovascular conditions. For instance, the European Journal of Preventive Cardiology recently questioned whether BFR might represent the "missing piece" in cardiac rehabilitation[24]. Available studies report promising findings. A recent review by Angelopoulos et al[25] concluded that BFR training is not only safe—potentially safer than traditional high-intensity exercise—but also effective in improving muscle strength, mass, and functionality. More specifically, Kambič et al[26] investigated the effects of an eight-week BFR intervention (two sessions per week) in patients with coronary artery disease three months after a cardiovascular event. The results showed no significant hemodynamic or biochemical differences between knee extensions with and without BFR, suggesting it was safe while still improved muscle strength.
Similarly, Ogawa et al[27] applied BFR training to the lower limbs of patients following cardiac surgery, reporting findings consistent with prior studies—BFR training was safe and improved both muscle size and function. Most recently, Wu and Liu[28] studied 44 patients undergoing upper-limb BFR training and observed improvements in cardiac function, functional status, and quality of life.
Collectively, these findings suggest that BFR training may serve as a safe and effective adjunct to conventional cardiac rehabilitation programs. Given the growing interest in low-load exercise strategies for cardiovascular populations and the emerging evidence supporting BFR training, a comprehensive review is warranted to critically evaluate its safety, efficacy, and clinical applicability in individuals with CVD in particular in acute and long-responses in cardiovascular function. This narrative review synthesizes current evidence on BFR training in CVD populations, with an emphasis on its programming, safety, efficacy, and disease-specific applications.
BFR IN CVD
Considering the aforementioned data, the authors conducted a literature search on the application of BFR training in populations with CVD. To conduct the search the Web of Science and Scopus databases were consulted for articles published in English or Spanish, without restrictions on publication year. The search strategy aimed to identify studies that investigated the use of BFR in individuals with CVD not including hypertension patients. Article selection was performed in pairs, and only studies that implemented an experimental BFR intervention-regardless of study design or whether outcomes were acute or long-term-were included.
Given the novelty of this research area and the heterogeneity of the few studies identified (e.g., types of cardiovascular pathology, BFR methodologies, outcome measures), no statistical pooling of results was performed; instead, a qualitative synthesis and analysis of the findings was undertaken. In Table 1, the study using BFR has been summarized in patients with CVD[29-35].
Table 1 Summary of studies using blood flow restriction in patients with cardiovascular disease.
Ref.
Study groups
Study population
Exercise modality
Training protocol (Exercises, intensity, sets x reps or time, rests, velocity contractions)
Patients with congestive heart failure. 63.66 ± 8 years
BFR-RT
BFRRT: 4 sets of bilateral knee-extensions to the point of volitional fatigue at a load corresponding to 30% of maximal dynamic strength. 30 seconds inter-set recovery in which the cuffs remained inflated. RIC: 4 cycles of 5 minutes upper arm ischemia followed by 5 minutes of reperfusion. Control: No treatment
BFRRT: 3 × 8-12 reps at 30%-40% 1-RM. 45 seconds inter-set rest interval. Cadence: 1 second concentric, 2 seconds eccentric. CON (aerobic rehabilitation): Interval leg cycling at the 60% to 80% of maximal heart rate (5 intervals of 5 minutes of workload cycling followed by 2 minutes of loading cycling) and cadence 50 to 60 rpm
8 weeks
Not stated (baseline: 2 ×/week). 3 ×/week (control)
Patients with stable ischemic heart disease, 57 ± 6 years
BFR-RT
Low-intensity RT. 4 sets (1 set of 30 rep + 3 sets of 15 rep) of bilateral knee extension exercise with a load of 20% 1RM. 30-second rest between each set. Control: Same exercise without BFR
Patients with ischemic heart disease, 52 ± 4 years
KAATSU-RT
Low-intensity KAATSU RT, 4 sets (1 set of 30 rep + 3 sets of 15 rep) of leg press, leg curl and leg extension. 1 min rest between each set. 20%-30% of 1RM. 1.5 seconds for each phase (concentric-eccentric)
Early post-cardiac surgery patients. 69.6 ± 12.6 years
KAATSU-RT
KAATSU RT: Seated knee extension and flexion and leg press. 1.5 seconds for each phase (concentric-eccentric). 3 sets of 30 repetitions for each exercise with 30 second of inter-set rest. 20%-30% 1RM. Control (aerobic cardiac rehabilitation): 30 min aerobic exercise at anaerobic threshold on a cycle ergometer
The BFR protocols employed across the studies show considerable heterogeneity in terms of exercise modality, training variables, and occlusion parameters. Most interventions combined low-load resistance training (20%–40% 1RM) with BFR, typically involving 4 sets (1 × 30 + 3 × 15 repetitions) and short inter-set rests (30–60 seconds). Some studies also incorporated aerobic training (e.g., cycling at 40%-70% VO2peak) under BFR conditions.
The duration of interventions ranged from acute (single-session) protocols to long-term programs lasting from 6 weeks to 6 months, with a frequency of 2-3 sessions per week. Occlusion was predominantly continuous and applied at the proximal region of the limbs, using cuff pressures ranging from 100 mmHg to 250 mmHg or relative values [e.g., 50% arterial occlusion pressure (AOP) or 15-20 mmHg above resting systolic pressure]. Cuff widths varied from narrow bands (30 mm) to wider cuffs (up to 90 mm), and occlusion was typically pneumatic. The velocity of contractions was often controlled, with concentric and eccentric phases ranging from 1 to 2 seconds.
EFFECTIVENESS OF BFR THERAPY IN CVD
A growing number of studies have explored the physiological adaptations and clinical applications of BFR training within CVD contexts. Table 2 summarizes the main findings of the included studies along with safety and compliance concerns.
Table 2 Summary of the main findings of the included studies on blood flow restriction in patients with cardiovascular disease.
n = 7 (7 men). 52 ± 4 years. Patients with ischemic heart disease
Chronic effects: ↑↑ leg press, leg curl and leg extension strength, ↑↑ muscle CSA of quadriceps femoris, hamstring and adductor, ↑↑ VO2peak, ↑↑ VO2AT, (NC) IGF-1, (NC) hsCRP
The evidence from current studies suggests that BFR training, both as resistance and aerobic interventions, is effective in improving several physiological and functional outcomes in cardiovascular patients. Acute interventions demonstrated increased muscle activation in both upper and lower limbs[29], whereas chronic protocols consistently showed significant improvements in muscle strength, hypertrophy, and functional capacity[27,30-34]. Patients with coronary artery disease experienced reduced systolic and diastolic blood pressure[26,32], and those with heart failure improved peak VO2 and inflammatory profiles[35]. Some studies also noted enhanced mitochondrial function, quality of life, and walking speed. Collectively, these findings highlight the potential of BFR training as a complementary intervention for improving muscular and cardiovascular adaptations in this population.
However, despite BFR training appears to improve functional and some cardiovascular parameters, its underlying physiological mechanisms remain insufficiently explored. The role of local hypoxia in stimulating hypertrophic pathways (e.g., mTOR, VEGF), enhancing endothelial function, or modulating autonomic balance has been proposed but rarely measured directly in clinical populations. Moreover, key cardiovascular markers such as heart rate variability, arterial stiffness, baroreflex sensitivity, and long-term cardiovascular outcomes (e.g., hospitalization or major adverse events) are not routinely assessed. Integrating mechanistic outcomes into future randomized controlled trial is essential to elucidate the systemic impact of BFR and support its theoretical rationale in cardiovascular rehabilitation.
SAFETY OF BFR IN CVD
Beyond physiological outcomes, researchers have explored the feasibility and tolerability of BFR in clinical settings. Ogawa et al[27] demonstrated its safety in post-cardiac surgery patients, while Parkington et al[36] investigated its potential in PAD patients with intermittent claudication. Additionally, concerns about patient adherence, discomfort, and risks related to thrombosis have been discussed in systematic evaluations like those of Nascimento et al[23,37].
According to the studies reviewed, BFR training was shown to be generally safe for cardiovascular patients, with no serious adverse events reported. Mild vertigo was observed in all participants in one study[30] while Madarame et al[33] noted transient increases in noradrenaline, D-dimer, and C-reactive protein, suggesting an acute physiological response rather than adverse outcomes. Importantly, studies involving patient’s post-myocardial infarction or post-cardiac surgery[27,33] did not report any complications related to the intervention. Adherence rates, when reported, were consistently 100%, supporting the feasibility and tolerability of BFR protocols in clinical settings. However, some studies lacked detailed safety reporting, underscoring the need for standardized adverse event documentation in future trials.
Concerns regarding vascular integrity, endothelial function, and arterial stiffness have also been debated. While some studies, such as those by Maga et al[38], indicate favorable endothelial adaptations, others, including Kambič et al[26] and Zota et al[39], report neutral or unclear effects on arterial stiffness, underscoring the need for further investigation.
Acute hemodynamic responses include transient increases in blood pressure, heart rate, and vascular resistance, induced by an exaggerated exercise pressor reflex[40] even in healthy young people, assuming a concern regarding safety[41], requiring controlled supervision in patients with unstable conditions[33,39]. Thrombosis risk remains a debated issue, though studies in stable patients with ischemic heart disease and hypertension indicate that markers like D-dimer and fibrinogen remain within normal ranges following BFR exercise[33,37]. Risk stratification tools have been proposed to ensure that BFR is applied safely, particularly in clinical populations with comorbidities[23].
To enhance the safety profile, it is recommended that explore personalized cuff pressures (40%–80% arterial occlusion) and exercise modalities (resistance vs aerobic BFR) to optimize benefits while minimizing risks[26,42] and monitor blood pressure before and after each set of BFR training.
Although most studies reported no serious adverse events during or after BFR training, detailed safety data were often lacking. Few trials systematically monitored key safety indicators such as blood pressure variability, thrombotic markers (e.g., D-dimer, fibrinogen), or autonomic responses. Additionally, most interventions were short-term, ranging from 4 to 24 weeks, with only one study extending to 6 months. This precludes a thorough assessment of long-term safety, especially in high-risk populations. Future studies should include standardized safety monitoring protocols and examine the effects of BFR training over periods longer than one year, particularly in patients with advanced heart failure, refractory hypertension, or unstable cardiovascular conditions.
CRITICAL APPROACH TO THE STATE OF ART
Several methodological limitations have been identified in studies examining BFR training in cardiovascular populations. One of the major limitations of the current body of evidence is the small sample sizes and the heterogeneity of study populations. Many included trials were pilot studies or had fewer than 20 participants, and patient populations ranged from individuals with coronary artery disease to those recovering from cardiac surgery. This variability restricts the generalizability of findings and highlights the need for larger, well-powered randomized controlled trials with more homogeneous CVD cohorts or stratified subgroup analyses to enhance external validity. In addition, limiting statistical power and generalizability (e.g., Ishizaka et al[31], Kambič et al[26,32]; Madarame et al[33], Tanaka and Takarada[35]; Ogawa et al[27]), and issues with randomization and blinding, may introduce bias (Kambič et al[26,32]). The lack of control over confounding factors such as medication use further complicate result interpretation.
A major challenge for clinical implementation is the wide variability in BFR protocols across studies. The lack of standardization makes it difficult to draw clear clinical recommendations or define an optimal protocol for specific CVD subgroups. Future research should aim to directly compare protocol parameters (e.g., pressure levels, cuff characteristics, training type) to develop evidence-based guidelines for safe and effective BFR application in cardiovascular populations.
Short intervention durations may be insufficient to elicit meaningful adaptations, and variability in BFR pressure application due to individual characteristics (e.g., blood pressure, limb circumference) can affect outcomes[33]. Additionally, concerns regarding the accuracy of outcome measurements (e.g., BIA in heart failure patients; Ogawa et al[27], limited generalizability to broader patient populations, and absence of appropriate control groups[33] highlight the need for larger, well-controlled studies with standardized protocols to clarify the efficacy and safety of BFR in cardiovascular rehabilitation.
Therefore, further research should take this information into account, along with the potential inclusion of other parameters, relevant in CVDs, that have not yet been studied, such as heart rate variability as an indirect indicator of autonomic nervous system balance.
CONCLUSION
Collectively, the use of BFR training in individuals with CVD appears to be a potentially safe and effective and promising exercise strategy to improve muscle strength, functional capacity, vascular health, and cardiorespiratory fitness. Those benefits lead to functional improvements, while minimizing cardiac strain when tailored to individual needs. Both acute and chronic interventions demonstrated favorable adaptations without serious adverse events. Most protocols applied low to moderate loads (10%–40% 1RM), continuous occlusion, and session frequencies of 2–3 times per week, using pressures tailored to resting systolic values or percentage of arterial occlusion pressure. Adherence rates were consistently high (often 100%), reinforcing its feasibility. Nevertheless, some cardiovascular and inflammatory markers (e.g., D-dimer, noradrenaline, C-reactive protein) showed acute increases in specific studies, highlighting the need for further monitoring. Additionally, several physiological parameters remain unexplored, and future research should aim to expand knowledge on long-term cardiovascular outcomes, arterial stiffness, endothelial function, and autonomic regulation to fully establish BFR's clinical utility in this population. Individualized protocol optimization and risk stratification for high-risk patients remain critical areas for future research. Furthermore, cautious application is vital in patients with advanced or uncontrolled conditions.
The accumulated evidence supports the incorporation of BFR training as a valuable adjunct to conventional rehabilitation in patients with CVD. Its ability to induce gains in muscle strength, functional capacity, and aerobic performance using low training intensities makes it especially advantageous for populations with limited exercise tolerance or those in early recovery stages. BFR protocols-particularly those involving resistance exercises at 20%–40% of 1-RM or aerobic training at submaximal intensities-can be safely implemented 2-3 times per week under clinical supervision.
Given the favorable safety profile reported in most studies and the high adherence rates, BFR training may be introduced progressively into cardiac rehabilitation programs, including in-hospital settings, outpatient clinics, or supervised community environments. It is particularly beneficial for improving lower-limb muscle mass and strength, enhancing gait performance, and counteracting sarcopenia-related risks, all of which are critical components of functional independence in this population.
However, clinicians should carefully consider individual cardiovascular risk profiles, select appropriate cuff pressures (e.g., 40%-50% of AOP or slightly above resting systolic values), and monitor patient responses, especially during the initial sessions. Mild and transient adverse effects (e.g., dizziness or discomfort) may occur, and continuous supervision is recommended. As some acute changes in hemodynamic or inflammatory markers have been observed, BFR should be introduced cautiously in patients with unstable cardiovascular status or uncontrolled hypertension. The integration of BFR may represent a significant step forward in expanding the therapeutic toolkit for cardiovascular rehabilitation.
Despite the limited available literature and the absence of any statistical analysis in our review, the general parameters for implementing a BFR exercise program in individuals with CVD are detailed in Table 3.
Table 3 Main setting for programming blood flow restriction in cardiovascular disease.
Programming variable
Details
Exercise protocol
Type of exercise
Resistance training was common, using exercises such as knee extension, leg press or biceps flexion. Aerobic exercise was also employed (i,e. cycle ergometer)
Exercise intensity
Low intensity predominated: Resistance exercise at 10%-40% of 1RM; aerobic exercise at about 40%-70% of estimated maximal oxygen uptake (VO2max) or 60%-80% heart rate
Sets and repetitions
Typical protocol: 1 × 30 reps followed by 3 × 15 reps. Other variations included 3 × 15 reps or 3 × 30 reps
Rest interval
Rest periods ranged from 30 to 60 seconds between sets
Targeted muscles/Limbs
Both lower limbs (e.g., thigh/knee extensions, leg press) and upper limbs (e.g., elbow flexion) were trained; many protocols used bilateral exercise
Session frequency
Varied by protocol-examples include once per week in acute sessions and twice or three sessions per week in multisession studies
Intervention duration
Ranged from single sessions or 1–3 acute sessions to multiweek protocols (e.g., 8-16 sessions over 8 weeks or 3 months). Chronic effects remain poorly characterized
BFR protocol
BFR pressure values
Highly variable: Examples include fixed pressures of 200 mmHg, ranges of 100–250 mmHg, 50% of AOP, or 15-20 to 40-80 mmhg > resting SBP
Pressure determination
Methods included arbitrary fixed pressures, percentages of SBP or percentage of AOP. A lack of consistent use of % AOP was noted
Cuff width
Varied widely-from 3 centimeters (cm) inelastic cuffs to 23 cm. Wider cuffs (> 12 cm) are recommended for safety and comfort, as they require lower inflation pressures to achieve occlusion
Cuff type
Both pneumatic cuffs with manometers and inelastic cuffs were used.
Occlusion protocol
Occlusion was applied continuously throughout sets and rest intervals. Cyclical occlusion–reperfusion has been discussed in heartfailure contexts but was not detailed in these acute/shortterm studies
Provenance and peer review: Invited article; Externally peer reviewed.
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Specialty type: Cardiac and cardiovascular systems
Country of origin: Spain
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P-Reviewer: Jeong T, PhD, Adjunct Professor, Lecturer, Postdoc, Researcher, South Korea; Xu TC, MD, PhD, Head, Professor, China S-Editor: Liu H L-Editor: A P-Editor: Xu J
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