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Reliability of Ankle-Brachial Index Measurements: A Comparison of Standard and Vascular Blood Pressure Cuffs

Chesbro, Steven B. PT, DPT, EdD, GCS; Asongwed, Elmira T. MS, RN, CNE; John, Emmanuel B. PhD, BSPT; Haile, Nolawit PT, MPT

doi: 10.1097/TGR.0b013e31828aee0d
Original Articles

An ankle-brachial index (ABI) is determined by comparing blood pressures of the extremities. No study that compared the blood pressure measurements obtained by standard or vascular cuffs was found. This study investigated the reliability of ABI measures using standard and vascular pressure cuffs. Two raters measured 480 systolic blood pressures of 10 healthy participants using standard and vascular cuffs. Intrarater reliability for standard cuffs was weak (intraclass correlation coefficient [ICC] = 0.42–0.63) and moderate to strong for vascular cuffs (ICC = 0.70–0.87). Interrater reliability was moderate to strong for both standard and vascular cuffs (ICC = 0.83–0.96). Reliability of ABI measures with vascular cuffs was moderate to strong. The results of this study suggest and recommend the vascular cuff for accurate measures to determine reliable ABI values. If a standard cuff is used, the blood pressure should be measured twice and averaged for the ABI calculation.

Department of Physical Therapy, Alabama State University, Montgomery, Alabama (Dr Chesbro); Department of Nursing and Health Professions, University of the District of Columbia, Washington, District of Columbia (Ms Asongwed); Department of Physical Therapy, Radford University, Radford, Virginia (Dr John); and Arlington Musculoskeletal Center, Arlington, Virginia (Ms Haile)

Correspondence: Steven B. Chesbro, PT, DPT, EdD, GCS, Department of Physical Therapy, Alabama State University, 915 S. Jackson St, Montgomery, AL 36104 (

This research was presented at the 2009 Annual Conference & Exposition of the American Physical Therapy Association.

The University of the District of Columbia, Department of Nursing and Allied Health, Research Infrastructure in Minority Institutions (RIMI) grant from the National Institute of Minority Health.

The authors of this study have no known conflict of interest related to this work.

© 2013Wolters Kluwer Health | Lippincott Williams & Wilkins