The impact of cuff width and biological sex on cuff preference and the perceived discomfort to blood-flow-restricted arm exercise

Objective: To investigate the influence of cuff width, sex, and applied pressure on the perceived discomfort associated with blood flow restriction at rest and following exercise. Approach: Experiment 1 (n  =  96) consisted of four sets of biceps exercise to failure with a narrow and wide cuff inflated to the same relative pressure. Experiment 2 (n  =  87) compared two wide cuffs, one of which was inflated to a relative pressure obtained from a narrow cuff. Experiment 3 (n  =  50) compared the discomfort of wide and narrow cuffs at rest. Effects are presented as median δ (95% credible interval). Main results: There was no sex effect for any variable of interest. In Experiment 1, the narrow cuff resulted in less discomfort than the wide cuff (39.3 versus 42.5; median δ  −0.388 (−0.670, −0.109)). Participants also rated the narrow cuff as more preferable. Experiment 2 found that a wide cuff inflated to a narrow cuffs pressure resulted in greater discomfort than a wide cuff (44 versus 40.9; median δ: 0.420 (0.118, 0.716)). Experiment 3 found no difference between cuff widths. Significance: Blood flow restricted exercise with a narrow cuff results in less discomfort than a wider cuff inflated to the same relative pressure. This effect is not observed at rest and suggests that the wide cuff produces a differential environment compared to a narrow cuff when combined with exercise. Additionally, applying a pressure meant for a narrow cuff to a wide cuff augments the applied pressure and subsequent discomfort to blood flow restricted exercise.