What’s The Difference?
Last month (April 2021) SmartTools Plus based in Cleveland, OH launched their 3rd and the latest version of the Blood Flow Restriction (BFR) SmartCuff System. This long-awaited launch was a welcome event as the original estimated release date of Fall 2020 was greatly delayed. COVID19, engineering and supply chain disruptions didn’t help with production slowdowns and manufacturing glitches. But, in my opinion, the wait was worth it. The folks at SmartTools knocked it out of the proverbial park.
Here is a comparison of the SmartCuff versions…
|Model||Automatic Personalized Pressure||Can Establish LOP||Manual Pressure Setting||Ischemic Pre Conditioning Protocol||The pump can be removed from cuffs||Autoregulation Feature|
|GEN2||(with external doppler)|
WHY THE CHANGE?
Ever since the launch of SmartCuffs Gen1 in 2016, the goal has been to manufacture a safe, affordable and effective Blood Flow Restriction (BFR) System for health care providers and strength and conditioning specialists. The previous versions (Gen1 & Gen2) required specialized training to determine limb occlusion pressure (LOP) using an external doppler. The external doppler allowed personalized pressures to be established for each individual which helped ensure safe and effective cuff pressures were being used. The ability to establish limb occlusion pressures differentiated the SmartCuffs system from the competitors who use arbitrary pressures. The drawback to this system was using an external doppler was time-consuming and sometimes difficult, especially for non-healthcare providers. The Gen3 system aimed at taking away the need for the additional step and equipment of using an external doppler to establish limb occlusion pressure.
LOP or AOP (Arterial Occlusion Pressure as it is sometimes referred to), is the amount of pressure required to fully occlude the venous and arterial blood flow into the involved limb. The LOP is individualized for each person based on many factors but the most substantial of these factors are limb size, cuff width, and cuff materials. We believe establishing individualized LOP is a vital step for safe and effective BFR and making this step easier and part of the set-up process makes this step quicker and included in the cuff inflation. Once the limb occlusion pressure is found, a percentage of the limb occlusion pressure is used to inflate the cuffs for exercise. The limb occlusion pressures currently recommended in the scientific literature are:
Upper Extremity: 40-50%
Lower Extremity: 60-80%
Since cuff inflation now included establishing personalized pressures, a consumer version could be developed that was easy to use, safe, and effective for non-healthcare providers and strength and conditioning specialists.
Since 2016, there have been more and more consumers wanting to use BFR cuffs for home use. To meet this demand, SmartTools wanted to bring a consumer version that allowed simple, safe, and effective BFR training for the end-user. To accomplish this, personalized pressures would have to be established quickly and easily in one small, light, portable unit. Under much internal discussion, to ensure safety for the end-user, certain functions of the Gen3 PRO were not included in the Gen3 system. Most of these differences have to do with protocols that use higher pressures (like Ischemic Pre Conditioning or IPC) and more advanced features like autoregulation. Removing some of these more advanced features allowed the consumer version to be simpler to use and more affordable.
Both the Gen3 and Gen3 Pro systems use the same upgraded cuffs from the Gen2 cuffs. In previous versions, there were 5 sizes of cuffs to ensure proper fitting. After much customer feedback, the number of cuffs was reduced from 5 to 3 for fewer space requirements and simpler sizing. In addition, the smallest size was reduced in width for more comfort in the upper extremity. Although the cuffs were reduced in width, they are still considered wide because the small cuffs are larger than 5cm.
Unlike Apple products which usually require upgraded hardware during significant version changes (think charger and adapter changes with new iPhones), both new SmartCuffs Gen3 pumps will work with the Gen2 Cuffs. The new cuffs feature the research-supported and ever-popular single-chambered bladder design. Having a single bladder also differentiates the SmartCuff system from its competitors. The cuff materials have been upgraded so they are easier to clean. The valve and stem system has been upgraded for improved durability and reducing the requirement for lubricating the o-ring like had to be done with the Gen2 cuffs.
SIMILARITIES BETWEEN Gen3 & Gen3 PRO
Both Gen3 & Gen3 pumps are small, light, computerized, and will automatically calculate, set, and inflate to a personalized pressure.
Both the Gen3 and Gen3 Pro have the option to disconnect the hose from the cuffs for untethered exercise. This design allows for training on a field or in an area where leaving the pump on the floor or other equipment would not be safe and most individuals do not want to keep the pumps in a backpack while training. Untethered BFR is less cumbersome but with the pro version, you have the option of staying connected or not. Having two pumps, as in the PRO Elite system, allows for bilateral inflation and auto regulation.
Both units use a Lithium-Ion (Li-Ion) battery. Li-Ion batteries withstand rigorous use and provide fast recharging capabilities. Charging the battery fully before the first use for at least 6 hours is important. Keeping the battery charged is also important. A safety feature of the pumps is if the battery gets too low, personalized pressure cannot be established. Having the battery run out in the middle of an inflation cycle would not be safe.
Updating the firmware for the Gen3 & Gen3 PRO can be performed over the internet. Click here for a video on how to perform the firmware update.If you purchased the Gen3 and eventually want to upgrade to the Gen3 PRO, our engineers are working on ways for this to happen. Look for this update in the future.
DIFFERENCES BETWEEN Gen3 & Gen3 PRO:
What you will first notice about the two devices is the color. The SmartCuffs Gen3 Pro is silver and the SmartCuffs Gen3 is black.
The PRO pump has a longer hose. The longer hose is necessary if one wants to keep the pump connected to the cuffs during exercise. Only with the PRO version can one perform autoregulation. Autoregulation means the pump(s) remain connected to the cuffs and cuff pressures are maintained within a certain pressure window. Autoregulation tends to be more comfortable for individuals who are more sensitive or possibly not accustomed to intense exercise.
The PRO pump allows custom LOP selection. The provider can choose whatever pressure they feel is safe and appropriate for their client or patient. The Gen3 model offers preset LOP%’s according to an intensity level (Low, Medium, or High):
For the Legs, Low = 50% LOP, Medium = 65% LOP, and High = 80% LOP
SmartCuffs PRO has IPC (Ischemic Preconditioning) modes built right into the unit. Ischemic preconditioning mode is repeated bouts of full occlusion (100% LOP) and full repercussion (total release of pressure). This protocol is performed passively (no exercise) in a supine or prone position for 5 minutes of occlusion and 3 minutes of rest for 3-5 rounds. This protocol is used before heavy or intense exercise to reduce the muscle-damaging effects of the heavy exercise. Please note, we do not recommend exercising with these pressures and these pressures should only be used passively.
Gen3 will store the most recent limb occlusion pressure for both the upper and lower extremity. The reason for this is these cuffs are designed to be used by a single user. Once the personalized pressure is set, utilizing the previous pressure allows for quick inflation.
The Gen3 PRO does not store more than the most recent limb occlusion pressure in both the upper and lower extremity. At least while performing exercises within the same session, using the previous calculation speeds up the exercise process. We realize the ability to store your clients’/patients’ limb occlusion pressure for future use would be a great feature. Unfortunately, we would have to use a much more expensive electrical board with more memory, screen, and a larger battery to accomplish this. We thought keeping the size and price as low as possible was more important at this time but in future upgrades, we will be searching for ways to store more information within the unit.
Instead, on the PRO version, you can manually set the pressure you want.
SmartCuffs have come a long way in the past 6 years since the original Gen1 cuff launched in 2016. There are still many features and options we want to include in future models. We want to hear from our customers about what they like and what they would like to see improved in our systems. We are the only BFR manufacturer that has changed its system 3 times in the past few years. We hope this shows a dedication to continual improvement, safety, reliability, and ease of use. Of course, we will always strive to have high-quality health and medical equipment at affordable pricing with ease of use.