An Automated Blood Flow Restriction Device Is Reliable, but Not Valid, for Determining Lower Limb Occlusion Pressure in Resistance-trained Adults

Abstract

Lang, D, Fallo, X, and Bennett, H. An automated blood flow restriction device is reliable, but not valid, for determining lower limb occlusion pressure in resistance-trained adults. J Strength Cond Res XX(X): 000–000, 2026—Blood flow restriction (BFR) exercise can improve strength, hypertrophy, and aerobic performance. Accurate limb occlusion pressure (LOP) assessment is essential for safe prescription. The AirBands is a novel automated BFR device that estimates LOP using integrated sensors, making LOP assessment easier. However, its validity and reliability are not well established in resistance-trained individuals. This study evaluated the concurrent validity of the AirBands compared with a handheld Doppler ultrasound for lower limb LOP, and its test-retest reliability, in resistance-trained adults. Twenty-six resistance-trained adults (14 males, 12 females; 24.2 ± 4.7 years) participated. For validity, LOP was measured using AirBands and Doppler in randomized order, using the same cuff. For reliability, automated LOP was measured twice, 10 minutes apart. Agreement was assessed using Bland-Altman limits of agreement and intraclass correlation coefficients (ICC). No significant difference was observed between manual (231.7 ± 17.8 mm Hg) and automated (230.8 ± 38.3 mm Hg) LOP (mean difference −0.8 mm Hg; p = 0.928), although validity ICC was poor (0.236, 95% confidence interval [CI] = −0.293 to 0.641). Bland-Altman analysis indicated proportional bias, with overestimation at lower values and underestimation at higher values. Reliability showed no significant difference between test 1 (243.0 ± 37.5 mm Hg) and test 2 (242.3 ± 40.5 mm Hg) (mean difference 1.0 mm Hg; p = 0.816) and good reliability (ICC = 0.862, 95% CI = 0.715 to 0.936). AirBands demonstrates good test-retest reliability but poor concurrent validity vs. Doppler ultrasound. Clinicians should confirm automated values using a Doppler ultrasound before prescribing BFR.