Law enforcement faces challenges in managing resistant subjects. The Crossover Arm Control (CAC) is a restraint technique designed to limit a subject’s mobility without requiring the restrainer to apply body weight. We conducted a prospective study to assess autonomic responses during CAC. 20 participants ages 20 - 65 were instructed to resist CAC application for 1 minute. Vital signs were monitored, and ultrasonography was used to assess blood flow. Throughout CAC application, oxygen saturation and tissue perfusion were maintained. The technique does not impede blood flow nor cause carotid artery constriction.
AlexanderJKHillierASmithRM, et al. (2007) Beta-adrenergic modulation of cognitive flexibility during stress. Journal of Cognitive Neuroscience19: 468–478. https://doi.org/10.1162/jocn.2007.19.3.468
3.
AmatJPaulEZarzaC, et al. (2006) Previous experience with behavioral control over stress blocks the behavioral and dorsal raphe nucleus activating effects of later uncontrollable stress: role of the ventral medial prefrontal cortex. Journal of Neuroscience26: 13264–13272. https://doi.org/10.1523/JNEUROSCI.3630-06.2006
4.
ArnstenAFT (2009) Stress signaling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience10(6): 410–422. https://doi.org/10.1038/nrn2648
BarattaMZZarzaCMGomezDM, et al. (2014) Selective activation of dorsal raphe nucleus-projecting neurons in the ventral medial prefrontal cortex by controllable stress. European Journal of Neuroscience30(6): 1111–1116. https://doi.org/10.1111/j.1460-9568.2009.06867.x
7.
BozemanWPStopyraJPKlingerDA, et al. (2018) Injuries associated with police use of force. Journal of Trauma and Acute Care Surgery84(3): 466–472. https://doi.org/10.1097/TA.0000000000001783
8.
BozemanWHallCKlingerD, et al. (2022) Safety of vascular neck restraint applied by law enforcement officers. Journal of Forensic and Legal Medicine92: 102446. https://doi.org/10.1016/j.jflm.2022.102446
9.
BrameRBushwaySDPaternosterR, et al. (2014) Demographic patterns of cumulative arrest prevalence by ages 18 and 23. Crime & Delinquency60(3): 471–486. https://doi.org/10.1177/0011128713514801
10.
ByardR (2011) Issues in the classification and pathological diagnosis of asphyxia. Australian Journal of Forensic Sciences43(1): 27–38. https://doi.org/10.1080/00450618.2010.482107
ConnerGv. (1989). 490 U.S. 386 (Supreme Court of the United States). Available at: https://www.loc.gov/item/usrep490386/ (Accessed 9 November 2025).
14.
DambacherFSSackATLobbestaelJ, et al. (2014a) The role of right prefrontal and medial cortex in response inhibition: interfering with action restraint and action cancellation using transcranial magnetic brain stimulation. Journal of Cognitive Neuroscience26(8): 1775–1784. https://doi.org/10.1162/jocn_a_00595
15.
DambacherFSSackATLobbestaelJ, et al. (2014b) The role of right prefrontal and medial cortex in response inhibition. Journal of Cognitive Neuroscience26(8): 1775–1784. https://doi.org/10.1162/jocn_a_00595
16.
DesmetCDDeschrijverEBrassM (2014) How social is error observation? The neural mechanisms underlying the observation of human and machine errors. Social Cognitive and Affective Neuroscience9(4): 427–435. https://doi.org/10.1093/scan/nst002
17.
DoumaMJHandleyAJMacKenzieE, et al. (2022) The recovery position for maintenance of adequate ventilation and the prevention of cardiac arrest: a systematic review. Resuscitation10: 100236. https://doi.org/10.1016/j.resplu.2022.100236
18.
GardnerTGAl-ShareffiE (2022) Regulating police chokeholds. Journal of Criminal Law & Criminology Online112: 111–125.
19.
HallCButlerC (2007) National Study on Neck Restraint in Policing. Government of Canada.
20.
HebscherMGilboaA (2016) A boost of confidence: the role of the ventromedial prefrontal cortex in memory, decision-making, and schemas. Neuropsychologia90: 46–58. https://doi.org/10.1016/j.neuropsychologia.2016.05.003
JiangX (2018) Prefrontal Cortex: Role in Language Communication During Social Interaction. InTech.
23.
KimYKimSYoonS (2024) Emotion malleability beliefs matter in emotion regulation: a comprehensive review and meta-analysis. Cognition & Emotion38(6): 841–856. https://doi.org/10.1080/02699931.2024.2334833
24.
LiMLuSWuY, et al. (2010) Functional segregation of memory encoding and retrieval in the prefrontal cortex In: Proceedings of the IEEE/ICME International Conference on Complex Medical Engineering (CME2010). IEEE, pp. 1–6. https://doi.org/10.1109/ICCME.2010.5558865
MillerEK (1996) Neural mechanisms of visual working memory of prefrontal cortex of macaque. Journal of Neuroscience16: 5154–5157.
27.
MorettoGLaureiroRRongaI, et al. (2010) A psychophysiological investigation of moral judgment after ventromedial prefrontal damage. Journal of Cognitive Neuroscience22(8): 1881–1891.
ShackmanASarinopoulosIMaxwellJ, et al. (2006) Anxiety selectively disrupts visuospatial working memory. Emotion6(1): 40–61. https://doi.org/10.1037/1528-3542.6.1.40
33.
SingletaryEMCharltonNPEpsteinJL, et al. (2015) Part 15: first aid 2015 American heart association and American red cross guidelines update for first aid. Circulation132(Suppl 2): S574–S589. https://doi.org/10.1161/CIR.0000000000000269
34.
TassySOullierODuclosY, et al. (2012) Disrupting the right prefrontal cortex alters moral judgement. Social Cognitive and Affective Neuroscience7(3): 282–288. https://doi.org/10.1093/scan/nsr008
35.
TiesmanHMGwilliamMKondaS, et al. (2018) Nonfatal injuries to law enforcement officers: a rise in assaults. American Journal of Preventive Medicine54(4): 503–509. https://doi.org/10.1016/j.amepre.2017.12.005
