Comparison of Three Exercises for Evaluation of the Calf Muscle Pump
Objective: To evaluate accurately the calf muscle pump in patients with venous insufficiency using foot vein pressure measurements during three different exercises. Design: Prospective study in three groups, comparing patients with venous disease with controls. Setting: Second Department of Surgery, Tottori University Faculty of Medicine. Patients: Twenty normal legs, 29 legs previously affected by deep vein thrombosis and 36 legs with primary varicose veins. Main outcome measures: The foot vein pressure was measured during ankle dorsiflexions, knee-bending and walking on the spot at 40 paces per minute during which minimum ambulatory venous pressure (AVP) and venous refilling time (VRT) were assessed. Results: The three groups differed significantly from each other in AVP and VRT after dorsiflexion and in AVP during walking on the spot, but not after knee-bending. Conclusion: Dorsiflexion is the most useful exercise distinguishing various severities of venous insufficiency, but walking on the spot is more useful for accurately evaluating the calf muscle pump.