With the subjects supine, in a randomized order, either the wide (Hokanson, SC12, Bellevue, WA; 13.5 cm × 83 cm) or narrow (Kaatsu Master, Sato Sports Plaza, Tokyo Japan; 5 cm × 135 cm) cuffs were applied to the most proximal portion of each leg. The pulse at the ankle (arterial blood flow) was detected using a hand-held bidirectional Doppler probe placed on the posterior tibial artery. This site was chosen because femoral artery blood flow is difficult to measure with cuffs applied. Both auditory and visual signals from the Doppler probe indicated if the pulse was present.
The narrow cuffs were applied with an initial compressive force between 40 and 60 mmHg (Karabulut et al. 2011b (link)). The wide cuffs were applied tightly around the upper thigh; however, the device which inflates the wide cuffs does not allow an initial compressive force to be set. The narrow cuffs were connected to a Kaatsu Master Cuff inflator (Sato Sports Plaza, Tokyo, Japan); the wide cuffs were connected to an E 20 Rapid Cuff Inflator (Hokanson, Bellevue, WA). Both devices adjust cuff pressure automatically and actual cuff pressures were confirmed on the machines’ digital window. The same inflation protocol was used for both types of cuffs. The cuffs were first inflated to 50 mmHg for 30 s and then deflated for 10 s. Cuffs were then inflated to the subject’s SBP for 30 s and then deflated for 10 s. Cuff pressure was then increased incrementally by 40 mmHg (30 s inflation followed by a 10 s deflation) until the arterial flow was no longer detected during inflation. When arterial flow was no longer detected, cuff pressure was decreased in 10 mmHg units until arterial flow was present. Arterial occlusion pressure was recorded to the nearest 10 mmHg as the lowest cuff pressure at which a pulse was not present. This process was repeated with both the wide and narrow cuff devices with 5 min rest allotted between the procedures. Cuff pressures were increased up to but not over 300 mmHg. If subjects still had a detectable pulse at 300 mmHg cuff pressure, arterial occlusion pressure was recorded as “300 + mmHg.” Subjects in which arterial occlusion did not occur with the narrow cuffs were not included in the regression analysis (explained below).
The narrow cuffs were applied with an initial compressive force between 40 and 60 mmHg (Karabulut et al. 2011b (link)). The wide cuffs were applied tightly around the upper thigh; however, the device which inflates the wide cuffs does not allow an initial compressive force to be set. The narrow cuffs were connected to a Kaatsu Master Cuff inflator (Sato Sports Plaza, Tokyo, Japan); the wide cuffs were connected to an E 20 Rapid Cuff Inflator (Hokanson, Bellevue, WA). Both devices adjust cuff pressure automatically and actual cuff pressures were confirmed on the machines’ digital window. The same inflation protocol was used for both types of cuffs. The cuffs were first inflated to 50 mmHg for 30 s and then deflated for 10 s. Cuffs were then inflated to the subject’s SBP for 30 s and then deflated for 10 s. Cuff pressure was then increased incrementally by 40 mmHg (30 s inflation followed by a 10 s deflation) until the arterial flow was no longer detected during inflation. When arterial flow was no longer detected, cuff pressure was decreased in 10 mmHg units until arterial flow was present. Arterial occlusion pressure was recorded to the nearest 10 mmHg as the lowest cuff pressure at which a pulse was not present. This process was repeated with both the wide and narrow cuff devices with 5 min rest allotted between the procedures. Cuff pressures were increased up to but not over 300 mmHg. If subjects still had a detectable pulse at 300 mmHg cuff pressure, arterial occlusion pressure was recorded as “300 + mmHg.” Subjects in which arterial occlusion did not occur with the narrow cuffs were not included in the regression analysis (explained below).
