## 4 Discussion
### Limb Differences in Arterial Occlusion Pressure  
In this study, there were no statistically significant differences in the AOP between the DOM and NDOM legs using either the CONT or INCR cuff inflation protocol in either males or females (Table 3). The non-significant differences in the AOP between legs is in agreement with a recently reported [33] average difference of less than 1 mmHg between legs. Our data and that of [PERSON] et al. [33] is contrary to the results reported by [PERSON] et al. [32] who reported large significant differences in AOP between legs. Our data indicating that AOP is closely related to size of the limb (i.e., circumference) rather than thigh volume, thigh skinfold thickness, and blood pressure is in agreement with that of [PERSON] et al. [32]. [PERSON] et al. [33] recently reported that 47% of the variance in limb occlusion pressure was attributed to between participants and 6% of the variance was attributed to between legs. Although limb circumference is a primary determinant of AOP, other factors may also contribute to differences in AOP between individuals (e.g., training and fitness status, limb composition, vascular health, blood pressure, time of day, age, and measurement and random error) and between limbs (i.e., differences in the position of the cuff bladder on the leg) [52].  
Because there were no statistically significant differences in the AOP between the DOM and NDOM legs in both males and females in this study and that of [PERSON] et al. [33], one might conclude that measuring the AOP in only one leg prior to the use of BFR during exercise is necessary. This would be a misinterpretation of the data. Although themean difference in the AOP between the DOM and NDOM legs was relatively small, the actual differences ranged from \(-107\) mmHg to \(124\) mmHg using the CONT cuff inflation protocol and \(-107\) mmHg to \(110\) mmHg using the INCR cuff inflation protocol. Using a recommended cuff pressure during BFR during exercise of \(40\%\) to \(80\%\) of the AOP measured in just one leg could result in an under- or over-inflation of the cuff of up to \(88\) mmHg when using the INCR cuff inflation protocol to measure AOP and \(99\) mmHg when using the CONT cuff inflation protocol to measure AOP.  
In this study of \(40\) participants, the DOM leg was larger in \(24\) (\(60\%\)) of the participants, the NDOM leg was larger in \(13\) (\(32.5\%\)) of the participants, and the two legs were the same size in \(3\) of the participants. The larger leg had a higher AOP in \(19\) (\(47.5\%\)) of the participants while the smaller leg had a higher AOP in \(18\) (\(45\%\)) participants. The DOM leg had a higher AOP in \(26\) (\(65\%\)) of the participants and the NDOM leg had a higher AOP is \(14\) (\(35\%\)) of the participants. Thus, the DOM leg is not always the larger leg and the larger or DOM leg does not always have a higher AOP. This data is consistent with that recently reported by [PERSON] et al. [32].  
Measuring AOP in only one leg could result in cuff inflation pressures when using BFR during exercise that are unsafe or ineffective. Those who use BFR during exercise should not be naive of the potential differences in AOP between limbs. Our data suggest that AOP should be measured in each limb prior to the use of BFR during exercise.