Reversal of Lower Limb Edema by Calf Muscle Pump Stimulation

Objective We aimed to evaluate the efficiency of O-(beta-Hydroxyethyl)-rutosides (Oxerutin) in reducing the incidence of venous system disease among patients with calf muscle pump dysfunction secondary to immobilization due to lower-limb fractures. Methods A total of 60 patients with lower-limb fractures and immobilized in plaster casts were included in this study randomized into control (n = 30; mean: 30.37 ± 6.03 years; 73.3% males; no treatment) and experiment (n = 30; mean: 31.67 ± 4.76 years; 66.6% males; Oxerutin, 500 mg po q12hr) treatment groups. Doppler ultrasound was performed to evaluate the effect of oxerutin on the alterations in the venous circulation. Results Patients in the control group were determined to be more commonly affected from the below-knee immobilization in terms of venous dysfunction in the great saphenous vein in the below-knee region when compared with the patients in the oxerutin treatment group (46.7 vs. 13.3%, respectively; p = 0.011). Incidence of reflux in the small saphenous vein was more common in the control group during the healing period when compared with the experiment group (40.0 vs. 10.0%, respectively; p = 0.017). None of the patients developed venous thrombosis. Conclusions In conclusion, the impairment of the lower extremity muscle pump should be considered as an important risk factor for venous disease, and should be evaluated. O-(beta-Hydroxyethyl)-rutosides during 6–8 week cast immobilization for a lower limb fracture may be an effective prophylactic regimen in reducing the incidence of reflux in the below-knee superficial veins.

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Reversal of Lower Limb Venous and Lymphatic Pooling by Passive Non-Invasive Calf Muscle Pump Stimulation

2006 International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/iembs.2006.4398046 ◽

2006 ◽

Author(s):

Guruprasad Madhavan ◽

Jason P. Cole ◽

Carolyn S. Pierce ◽

Kenneth J. McLeod

Keyword(s):

Lower Limb ◽

Calf Muscle ◽

Muscle Pump ◽

Non Invasive ◽

Calf Muscle Pump

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Reversal of Lower Limb Venous and Lymphatic Pooling by Passive Non-Invasive Calf Muscle Pump Stimulation

2006 International Conference of the IEEE Engineering in Medicine and Biology Society ◽

10.1109/iembs.2006.260364 ◽

2006 ◽

Cited By ~ 4

Author(s):

Guruprasad Madhavan ◽

Jason P. Cole ◽

Carolyn S. Pierce ◽

Kenneth J. McLeod

Keyword(s):

Lower Limb ◽

Calf Muscle ◽

Muscle Pump ◽

Non Invasive ◽

Calf Muscle Pump

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Calf Muscle Pump Stimulation Increases Lower Limb Bone Density in Perimenopausal Women

Journal of Bone Biology and Osteoporosis ◽

10.18314/jbo.v4i1.1267 ◽

2018 ◽

Vol 4 (1) ◽

pp. 89-93

Author(s):

Kenneth James McLeod ◽

Carolyn Pierce

Keyword(s):

Bone Mineral Density ◽

Fluid Flow ◽

Lower Limb ◽

Calf Muscle ◽

Muscle Stimulation ◽

Mineral Density ◽

Nutrient Delivery ◽

Muscle Pump ◽

Calf Muscle Pump ◽

Perimenopausal Women

Nutrient delivery to bone tissue, as for all tissues in the body, is provided through interstitial fluid flow. This flow is driven by the differential fluid pressures between the intramedullary canal and the tissues outside of the bone. Correspondingly, reductions in tissue fluid pressure should enhance interstitial bone fluid flow, nutrient delivery, and thereby increase bone mineral density. This hypothesis was tested in a one year long pilot clinical study of healthy, employed, perimenopausal women (42 - 68 years). Soleus muscle (calf muscle pump) stimulation was utilized with the intent of increasing lower limb fluid return to the heart, serving to both reduce lower limb tissue pressures and to increase intramedullary pressures by increasing cardiac output. Dual-energy x-ray absorptiometry (DXA) assessments of bone mineral density (BMD) were obtained at 12 month intervals. Muscle stimulation usage ranged from 0.7 to 4.8 hours/work-day. Dose dependent responses between duration of daily soleus muscle stimulation and changes in both proximal femur BMD (+0.5% per hour of daily use; p = 0.05) and proximal tibia BMD (+1.5% per hour of daily use; p = 0.0004), were observed; no significant effect was observed at the lumbar spine. These results are consistent with the hypothesis that calf muscle pump stimulation, which is sufficient to reduce lower limb fluid pooling, is capable of significantly reducing the rate of bone loss in perimenopausal women as well as enhancing new bone formation.

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Calf Muscle Pump Stimulation as a Means to Reduce Symptoms of Fibromyalgia Syndrome

Biological Research For Nursing ◽

10.1177/1099800414546893 ◽

2014 ◽

Vol 17 (3) ◽

pp. 334-339 ◽

Cited By ~ 3

Author(s):

Lynn M. Baniak ◽

Carolyn S. Pierce ◽

Erik Hiester ◽

Kenneth J. McLeod

Keyword(s):

Fibromyalgia Impact Questionnaire ◽

Additional Treatment ◽

Calf Muscle ◽

Attrition Rate ◽

Widespread Pain ◽

Muscle Pump ◽

Calf Muscle Pump ◽

Revised Fibromyalgia Impact Questionnaire ◽

Change In Mean ◽

Quiet Sitting

Fibromyalgia (FM) is a debilitating chronic condition that often affects women in midlife with widespread pain that interrupts attempts to exercise. The purpose of this pilot study was to test the efficacy of calf muscle pump (CMP) stimulation as an adjuvant therapy for FM by (1) assessing the correlation of the level of symptoms, as measured by the revised Fibromyalgia Impact Questionnaire (FIQR), and blood pressure (BP), (2) measuring change in mean FIQR scores for subjects who use a CMP-stimulation device for 12 weeks, and (3) measuring the correlation of total device usage and the level of symptoms as measured by the FIQR. The 29 male and female participants (mean age = 47.3 years) were screened using the Widespread Pain Index (WPI), Symptom Severity (SS) score, and the FIQR. Participants were contacted weekly, and progress was assessed using the WPI, SS score, and the FIQR as well as general questions regarding responses to CMP stimulation. The attrition rate was high, which is not uncommon in studies of patients with FM. We found that diastolic BP was significantly inversely correlated with baseline FIQR scores during quiet sitting. Further, 12 weeks of CMP stimulation was associated with significant improvement in average FIQR scores at a rate of approximately −1.5 points per week ( R2 = .9; p ≤ .0001). Total device usage was strongly and inversely correlated with baseline FIQR scores ( R2 = .43; p = .02). These findings suggest that CMP stimulation may provide an additional treatment option for individuals with FM who are challenged to perform traditional forms of exercise.

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Calf muscle pump function as a predictor of all-cause mortality

Vascular Medicine ◽

10.1177/1358863x20953212 ◽

2020 ◽

Vol 25 (6) ◽

pp. 519-526

Author(s):

Meghana Halkar ◽

Jose Medina Inojosa ◽

David Liedl ◽

Waldemar Wysokinski ◽

Damon E Houghton ◽

...

Keyword(s):

Heart Failure ◽

Charlson Comorbidity Index ◽

Negative Impact ◽

Calf Muscle ◽

Study Objective ◽

Muscle Pump ◽

Calf Muscle Pump ◽

Comorbidity Index ◽

Predominantly Female ◽

Poor Outcomes

Calf muscle pump (CMP) promotes venous return from the lower extremity and contributes to preload and cardiac output. Impaired CMP function may reflect a measure of frailty or cumulative disease burden or may impede cardiac function. The study objective was to test the hypothesis that impaired CMP negatively impacts survival. Consecutive adult patients who underwent venous strain gauge plethysmography at the Mayo Clinic Gonda Vascular Laboratory (January 1, 1998 – December 31, 2011) were assessed for overall survival. Patients with venous incompetence, venous obstruction or unilateral calf pump dysfunction were excluded. Risk of mortality was assessed with Cox proportional hazard ratios and after adjusting for Charlson Comorbidity Index variables. Over the study period, 2728 patients were included in the analysis. Compared to patients with normal CMP, those with impaired CMP were older ( p < 0.001), predominantly female ( p = 0.01) and had higher mean Charlson scores ( p < 0.001). Patients with impaired CMP had a higher mortality rate at 5 (8.9% vs 2.4%), 10 (17.5% vs 5.9%), and 15 years (22.8% vs 8.3%) compared to those with normal CMP ( p < 0.001 for each comparison). Of patients with heart failure, those with impaired CMP had worse survival at each 5-year increment compared to those with normal CMP ( p < 0.05 at each increment). In conclusion, impaired CMP appears to be an independent predictor of poor outcomes after adjusting for variables within the Charlson Comorbidity Index. The association between impaired CMP, heart failure, and mortality may represent a negative impact on circulatory function or a surrogate measure of frailty.

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