Lops Writing Application For Android – 6A – As shown in the 1. video above. Adjust the pressure gauge before inflating the cuff to speed up the rate of air release.
6B – As shown in the 2. video just above. Before deflating the cuff below 230 mmHg, turn the valve counterclockwise on the pressure gauge to slightly increase the rate of deflation. Please note that only minor repairs are required. Be patient as it takes a while to get it right as practice makes perfect.
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3. Inflation to near 280 mmHg to allow more deflation rate through the valve on the pressure gauge before the pressure falls below 230 mmHg
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4. Show the correct pulse wave after the deflation rate has increased slightly. For the purpose of the lower body deflation period of 20-50 seconds from the moment you stop pumping.
Disclaimer: 230 mmHg is the highest measured pressure the device can determine, so if you have extra large thighs (> 75 cm) it is not possible to detect LOP. As an alternative way to determine the pressure, see if the training module “Calculate pressure” is convenient. read more about the module at /web-app-explained.
Limb occlusion pressure (LOP) can be used with different methods or devices. The use of LOP is considered the most beneficial way to adjust the pressure delivery setting to ensure a subocclusive and effective stimulus.
“Systolic blood pressure”, in the application interface displayed as “SYS”, is the 100% limb occlusion pressure (LOP) for a limb in a specific position with a specific cuff used for assessment. On the other hand, routine blood pressure measurements should be done with calibrated cuffs, not Fit Cuffs, but more on this below.
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The LOP device measures the smallest amount of pressure needed to block blood flow. It is essentially a physiological assessment similar to the common but time-consuming hand doppler method or the less valid pulse oximetry method.
LOP and Arterial Occlusion Pressure (AOP) can be used interchangeably for practical application and description. Both terms refer to the lowest tourniquet pressure required to stop arterial blood flow to the distal end of the cuff.
Please consider the physiological nature of LOP as inherently dynamic. Consequently, the LOP will change as you perform successive measurements due to the hemodynamic response (blood flow study) to exercise and external pressure stimuli.
LOP is defined as the minimum pressure required to stop arterial and venous blood flow in the corresponding limb, at a certain time, in a certain position with a certain cuff applied.
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Noordinn and others. (2009). So always consider the difference of 5-15% in SYS / LOP in relation to body position, e.g. standing vs sitting vs. lie
We recommend measuring LOP using the LOP device in a sitting or lying position. After the seated LOP check, please follow these recommendations for set pressure during lower body BFR training.
Pressure-Load Continuum in Blood Flow Restriction Exercise – When higher pressures are used, use lighter loads and vice versa.
The LOP device is used by oscillometric ie. analysis of arterial pulse waves and the absence of arterial pulse waves (CE 0197). When blood moves through the arteries between systolic and diastolic pressure, it causes vibration. This vibration travels through the air inside the cuff and is converted into an electrical signal by the LOP device’s pressure sensor, which ultimately produces a digital readout on the LED and app interface. This is basically the same physiological phenomenon measured by Handheld Doppler Ultrasound, which detects the loss of blood flow by auscultation (korotkoff sound).
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Independent comparative testing of the product in 3 separate research institutions worldwide have all shown good validity, namely Inter-Assessor Reliability (Correlation) and Test-Retest Reliability (Intra-Class Correlation Coefficient) – (ICC). The data show a difference of only 1-5% comparing the LOP device compared to the assessment of LOP by Handheld Doppler Ultrasound and the second “gold standard” Doppler Pulse Wave Ultrasound.
Good to know – the true “gold standard” for blood flow studies is “direct intra-arterial recording”.
The following universities participated in the Bluetooth device (v1.0) versus doppler ultrasound study: Lebanese University Faculty of Public Health&Gazi University Turkish Faculty of Sports Science and Institute of Physiotherapy ZHAW Swiss School of Health Professions.
El-Zein (2020) (Thesis) Using a Portable Bluetooth Device (v1.0) to Measure the Pressure Requirements of Blood Flow Restriction Exercise: A Validation Study
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“Based on the results of our study, we recommend the use of Fit Cuffs® portable Bluetooth device for objective and personal BFR training. This device is a valid, reliable and affordable substitute for other measuring devices, which are more expensive and more required. skill to use. that the use of Bluetooth devices will provide BFR practitioners with the ability to provide high quality services to their clients or patients, ensuring minimal risk and optimal results regardless of location.
“The inexpensive oscillatory device is a valid and reliable measuring device to determine AOP in the lower limb of healthy adults. For the upper limb, it can be concluded that the oscillatory device is a valid method to measure AOP compared to HH Doppler When both methods are compared with US Doppler, it appears less accurate and overestimates AOP at the upper end.It is recommended to take at least two measurements to determine the AOP using an oscillating device.
Schmidt (2021) (Thesis) Validity and reliability of an oscillating blood pressure measuring device to determine arterial occlusion pressure in healthy adults for a blood flow restriction exercise protocol: a cross-sectional study.
Figure 1 – Bell et al. (2020) – Relative (A) and absolute (B) changes of Pre in Limb Occlusion Pressure (LOP) and Systolic Blood Pressure (SYS) after isometric knee extension exercise.
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“Our findings show that changes in bone occlusion pressure measured by hand-held Doppler tracings are similar to traditional measures of brachial systolic blood pressure after isometric knee flexion exercise. .” – “Finally, this study supports the use of limb occlusion pressure measurement as an alternative measure of systolic blood pressure potential (if both cuffs are the same width).”
“The fact that brachial systolic blood pressure explains a significant amount of variance in arterial occlusion makes sense to show that they are basically measurements of the same thing, except that brachial SBP is measured on a different scale. on the cuff.”
“When the cuff is fully inflated to this pressure, no blood flow occurs through the artery. As the cuff is deflated below the systolic pressure, the decrease in pressure applied to the artery allows the blood to flow and ‘ maintain a vibration that can be detected on the artery wall.
Interestingly, oscillometry is currently used in the manufacture of autoregulated systems to determine LOP performed for bloodless surgery and also for Blood Flow Restriction Training (BFR). It is an auto-regulated tourniquet instrument with a pressure sensor and software to calculate LOP such as Delfi Medical Innovation Inc.:
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“The instrument attached to the cuff tourniquet increases the cuff pressure in stepwise increments of 10 mmHg, analyzes the pneumatic pressure pulsations caused in the bladder cuff by the arterial pressure pulsations in each cuff pressure increase, and uses this characteristic to determine the LOP.”
“The first method, ‘method LOP embedded’ [16], measures LOP by using a dual-purpose tourniquet cuff to monitor arterial pulsations in the condition limb by detecting pneumatic pressure pulsations in the relevant cuff from changes in limb volume as the cuff pressure gradually increases then.”
Arterial occlusion pressure (AOP) and LOP can be used interchangeably for practical applications. However, total limb occlusion (TOP) is another terminology used in BFR research to describe loss of pulsation. This method considers the hemodynamic response (blood flow) to constraints such as pressure variations associated with external or internal stimuli. So please consider, when measurements of the same part are repeated, the LOP will be very different due to the hemodynamic response to blood flow restriction and/or exercise.
The difference in LOP / AOP compared to TOP does not affect the pressure prescription in the clinical application of LOP, since the general recommendation of 40-80% of LOP is measured by LOP devices, handheld dopplers or pulse oximetry.
Limb Occlusion Pressure (lop) By The Lop Device
The results support that Doppler ultrasound has good reproducibility for measuring total obstruction pressure in the brachial artery. In addition, systolic and diastolic blood pressure should be considered as the main predictor variable to determine the total pressure barrier in the upper body.
If you want to know more about the LOP device (v1.1), vascular doppler and oscillatory blood pressure measurement, please see our Blog page (December 10 + February 4, 2020) and videos from the YouTube channel: @ BPM biosignals
Disclaimer: When determining normal blood pressure, you must use a cuff calibrated in terms of at least the width of the bladder (0.4) and the height of the bladder (0.8) in relation to the circumference of the limb you are checking . (Pickering et al. (2005)
Therefore, you cannot use the Fit Cuffs product selection for routine blood pressure measurements. Please also note that, when performing continuous and continuous LOP measurements, the SYS will vary due to the hemodynamic response as described above.
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