Limb dominance does not have a meaningful impact on arterial occlusion pressure

Abstract

Introduction: Limb dominancy has been suggested, by some, to influence arterial occlusion pressure (AOP). However, we hypothesized that the differences in AOP between the dominant and nondominant legs were more likely explained by differences in cuff position.

Aims: To determine the impact of limb dominance, composition, and cuff position on AOP in the context of error associated with measuring AOP twice on the same leg.

Methods: Fifty-eight adults (30 males) volunteered to have AOP measured on their dominant legs with the cuff bladder covering their inner thighs and on their nondominant legs with the bladder covering their inner and outer thighs (in random order). Thigh circumference and muscle and fat thicknesses were also measured on each leg.

Results: We found evidence for differences in AOP between legs [median δ of -0.222, 95% credible interval: (-0.429, -0.016)] when the cuff position was matched. The mean difference was -2.8 mmHg, and the 95% limit of agreement in a Bland-Altman plot was -24.8 to 19.0 mmHg. When plotting this alongside an error range (i.e., 95% limits of agreement) of taking the same measurement twice from our previous study (Spitz et al., 2020), 52 out of 58 measurements were within the error range. This difference was not due to the cuff position. Additionally, there was no evidence that thigh circumference or composition (muscle/fat thickness) moderated any difference between limbs.

Conclusion: The difference in AOP between limbs is small and is mostly indistinguishable from the difference observed from taking the measurement twice on the same limb.

Keywords: Doppler ultrasound; blood flow restriction; cuff position; limb composition; limb dominance; lower limb; variability.