![]() Each measurement was made three times by the same examiner, leaving one minute for a washout of the explorations of the radial pulse to avoid disturbances by mechanical stress at the vascular level. If any change in blood flow was detected, the examiner immediately reported it to the researcher, who registered the event as a “change”. Changes in the radial pulse were then observed for a 10 s time interval. Once the examiner was ready and heard the pulse through the stethoscope headphones, the main researcher indicated the beginning of the measurement by a visual signal over the heavy curtain. Digital stethoscope measurements were done first. Once the subject was ready, the first examiner proceeded to the room and used a dermographic marker to mark the reference point over the radial artery at which the evaluation was to be carried out, to ensure that it was the same in each subsequent measurement (approximately 2 centimetres above the radial styloid on the palmar side of the forearm). Thus, the examiners were completely blinded to the modification (or not) of the pressure applied to the artery by the main researcher. In addition to being visually concealed from the subject, the examiners were also acoustically concealed with the use of headphones connected to either the Doppler device or to the digital stethoscope, according to the case. ![]() Use of the curtain allowed us to divide the participant’s body into two working areas-the upper part, which was inside the cabin where the main investigator was modifying the brachial artery pressure (in the case of condition 2) and registering the vascular blood flow changes reported by the examiner, and the lower part, with the examiner standing by the subject’s feet (outside the cabin). In order to blind the evaluators, a cabin isolated from the exterior by a heavy curtain was designed. This way, the radial pulse of the 61 subjects was measured 3 times by 3 different evaluators, with a total of 549 measures for each diagnostic tool ( Figure 1). ![]() Prior to the study, all examiners were trained at using the two diagnostic devices. Three independent examiners carried out both procedures (digital stethoscope and Doppler sonography) on each subject. In conclusion, digital vascular auscultation seems to be a valid technique to examine blood flow changes of the radial artery in non-symptomatic subjects, and it could be useful for physical therapists when combined with provocative tests for the screening of possible thoracic outlet syndrome in patients. Stethoscope sensitivity was 95%, and specificity was 99%. A strong concordance between the two devices when detecting the “changes” or “no changes” in blood flow was demonstrated ( k = 0.936, p < 0.001). Both instruments demonstrated a high association between the identification of blood flow modifications or not and the assigned condition ( p < 0.001). The radial pulse was then measured three times with each diagnostic tool by three different blinded evaluators. Sixty-one non-symptomatic subjects (mean age of 52.5 ± 16.1 years) were assigned and evaluated under one of the following conditions: In condition 1, blood flow of the radial artery was not modified for condition 2, blood flow of the radial artery was modified using a pressure sleeve around the humerus. ![]() This study aimed to determine the validity of digital vascular auscultation for the assessment of changes in the radial pulse in healthy subjects, using Doppler sonography as a validated test referent. ![]()
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