The Physiological Effect of Graded Compression Stockings on Blood Flow in the Lower Limb: An Assessment with Colour Doppler Ultrasound

Objectives: To assess the physiological effect of low-pressure graded compression stockings (GCS) on the blood flow of the lower limb with the use of colour Doppler. Design: A randomised controlled study. Setting: X-ray Department in a teaching hospital. Patients: Forty-five healthy, adult, voluntary subjects. Method: Subjects were randomised into three groups to either wear thigh- or knee-length GCS of the same type or no stockings. The diameter and cross-sectional area of the femoral and popliteal veins and the peak venous velocities were measured with colour Doppler before the application of GCS and after 20 min bed rest with the stockings in situ. Results: Measurements showed a significant increase of the peak velocity in the femoral vein with thigh-length GCS ( p<0.002). There was a significant decrease of the popliteal vein diameter and cross-sectional area with thigh-length GCS ( p<0.05). There was no significant change in the knee-length GCS group and the control group, in which patients did not wear stockings. A paired t-test was used to determine the significance of the changes. Conclusions: Thigh-length GCS have an effect of increasing venous peak velocity in the femoral vein, hence decreasing venous stasis. Furthermore, they decrease the dilatation of the popliteal vein, which may reduce the risk of intimal tears occurring, which may contribute to venous thrombogenesis. Other methods can given more information in assessing the effect of various lengths of stocking on venous stasis.

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The Physiological Effect of Graded Compression Stockings on Blood Flow in the Lower Limb: An Assessment with Colour Doppler Ultrasound

Phlebology The Journal of Venous Disease ◽

10.1007/s005230050024 ◽

1999 ◽

Vol 14 (1) ◽

pp. 17 ◽

Cited By ~ 6

Author(s):

T. Benko¨ ◽

I. Kalik ◽

M. N. Chetty

Keyword(s):

Blood Flow ◽

Doppler Ultrasound ◽

Lower Limb ◽

Physiological Effect ◽

Colour Doppler ◽

Compression Stockings ◽

Colour Doppler Ultrasound

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Venous return in lower limb during heat stress

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1994.267.4.h1337 ◽

1994 ◽

Vol 267 (4) ◽

pp. H1337-H1340 ◽

Cited By ~ 4

Author(s):

P. Abraham ◽

G. Leftheriotis ◽

B. Desvaux ◽

M. Saumet ◽

J. L. Saumet

Keyword(s):

Blood Flow ◽

Heat Stress ◽

Lower Limb ◽

Venous Return ◽

Femoral Vein ◽

Fold Increase ◽

Cross Sectional ◽

Saphenous Veins ◽

Blood Flow Increase ◽

Cutaneous Blood

We used ultrasound to study venous return during heat stress. We measured venous cross-sectional area (CSA) and blood flow velocity (BFV) of nine femoral veins and nine saphenous veins. During heat stress, saphenous CSA increased from 4.7 +/- 2.6 mm2 (mean +/- SD) to 9.1 +/- 2.3 mm2 (P < 0.01), whereas femoral CSA was 22.7 +/- 9.5 mm2 at rest and 22.0 +/- 9.6 mm2 during heat stress (NS). Meanwhile, BFV increased from 0.06 +/- 0.02 to 0.30 +/- 0.10 m/s (P < 0.01) in the saphenous vein and from 0.14 +/- 0.08 to 0.38 +/- 0.23 m/s (P < 0.005) in the femoral vein. Maximal venous outflow (MVO) was the product of CSA and BFV. During heat stress, MVO showed an eightfold increase in the saphenous veins (from 22.7 +/- 18.2 to 180.7 +/- 86.7 ml/min) and a 2.5-fold increase in the femoral veins (from 143.4 +/- 52.9 to 354.0 +/- 126.9 ml/min). The results showed that one-half of the cutaneous blood flow increase during heat stress returned through the deep collecting veins in the lower limb. Thereafter, although there was no venodilation of deep veins compared with superficial veins, the deep veins remain the main pathway for the venous return during heat stress.

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Optimal parameters of blood flow restriction and resistance training on quadriceps strength and cross-sectional area and pain in knee osteoarthritis

Isokinetics and Exercise Science ◽

10.3233/ies-200235 ◽

2021 ◽

pp. 1-10

Author(s):

Waleed S. Mahmoud ◽

Ahmed Osailan ◽

Ahmed S. Ahmed ◽

Ragab K. Elnaggar ◽

Nadia L. Radwan

Keyword(s):

Blood Flow ◽

Resistance Training ◽

Knee Osteoarthritis ◽

Quadriceps Strength ◽

Sectional Area ◽

Occlusion Pressure ◽

Total Occlusion ◽

Cross Sectional ◽

Flow Restriction ◽

Low Intensity

BACKGROUND: Knee osteoarthritis (KOA) is one of the most common chronic diseases impacting millions of elderly people. OBJECTIVES: The study compared the effects of two intensities of partial blood flow restriction (BFR) with low-intensity resistance training on quadriceps strength and cross-sectional area (CSA), and pain in people with knee osteoarthritis (PwKOA). METHODS: Thirty-five PwKOA, aged 50–65, participated. Quadriceps CSA was measured by ultrasonography, quadriceps strength – by isokinetic dynamometry and pain by VAS. These outcome variables were obtained at the beginning of the study and re-evaluated eight weeks after the intervention. RESULTS: An interaction effect was present for quadriceps CSA (P= 0.042) and quadriceps strength (P= 0.006), showing that using 70% of total occlusion pressure with 30% 1RM had a more significant effect. Knee pain improved significantly through the main effect of BFR (P< 0.001), and low-intensity resistance training (P= 0.011). Pain improved more at 70% of total occlusion pressure, with 30% of 1RM (2.5 ± 1.06) than 50% total occlusion pressure with 10% of 1RM (5.77 ± 1.46). CONCLUSION: A combination of 70% of total occlusion pressure with 30% 1RM could be beneficial in PwKOA in improving pain, and increasing the quadriceps strength. The changes in the quadriceps strength could be a predictor for knee pain.

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Sequential alterations in the diameters of capillaries in rabbit skeletal muscle following deep transverse friction - a morphometric study

South African Journal of Physiotherapy ◽

10.4102/sajp.v61i2.174 ◽

2005 ◽

Vol 61 (2) ◽

Author(s):

M. A. Gregory ◽

M. N. Deane ◽

M. Marsh

Keyword(s):

Skeletal Muscle ◽

Blood Flow ◽

Muscle Blood Flow ◽

Biceps Femoris ◽

Cross Sectional Area ◽

Sectional Area ◽

Cross Sectional ◽

Biceps Femoris Muscle ◽

Beneficial Effects ◽

The Cross

Objective: The precise mechanisms by which massage promotes repair in injured soft tissue are unknown. Various authorshave attributed the beneficial effects of massage to vasodilation and increased skin and muscle blood flow. The aim of this study was to determine whether deep transverse friction massage (DTF) causes capillary vasodilation in untraumatised skeletal muscle. Setting: Academic institution.Interventions: Twelve New Zealand white rabbits were anaesthetised and the left biceps femoris muscle received 10 minutes of DTF. Following treatment, wedge biopsies were taken from the musclewithin 10 minutes of treatment (R1 - 4), 24 hours (R5 - 8) and 6 days(R9 - 12) after treatment. To serve as controls, similar biopsies weretaken from the right biceps femoris of animals. The samples were fixed, dehydrated and embedded in epoxy resin.Transverse sections (1µm) of muscle were cut, stained with 1% aqueous alkaline toluidine blue and examined with a light microscope using a 40X objective. Images containing capillaries were captured using an image analyser with SIS software and the cross sectional diameters of at least 60 capillaries were measured from each specimen. Main Outcome Measures: Changes in capillary diameter. Results: The mean capillary diameters in control muscle averaged 4.76 µm. DTF caused a significant immediate increase of 17.3% in cross sectional area (p<0.001), which was not significantly increased by 10.0% after 24 hours (p>0.05). Six days after treatment the cross-sectional area of the treated muscle was 7.6% smaller than the controls. Conclusions: This confirms the contention that DTF stimulates muscle blood flow immediately after treatment and this may account for its beneficial effects in certain conditions.

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Changes in lower extremity blood flow during advancing phases of pregnancy and the effects of special footwear

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.002617 ◽

2017 ◽

Vol 16 (3) ◽

pp. 214-219 ◽

Cited By ~ 2

Author(s):

Marta Gimunová ◽

Martin Zvonař ◽

Kateřina Kolářová ◽

Zdeněk Janík ◽

Ondřej Mikeska ◽

...

Keyword(s):

Blood Flow ◽

Venous Blood ◽

Cross Sectional Area ◽

Popliteal Vein ◽

Control Group ◽

Venous Disease ◽

Venous Blood Flow ◽

Sectional Area ◽

Cross Sectional ◽

Experimental Group

Abstract Background During pregnancy, a number of changes affecting venous blood flow occur in the circulatory system, such as reduced vein wall tension or increased exposure to collagen fibers. These factors may cause blood stagnation, swelling of the legs, or endothelial damage and consequently lead to development of venous disease. Objectives The aim of this study is to evaluate the effect of special footwear designed to improve blood circulation in the feet on venous blood flow changes observed during advancing phases of pregnancy. Methods Thirty healthy pregnant women participated in this study at 25, 30, and 35 weeks of gestation. Participants were allocated at random to an experimental group (n = 15) which was provided with the special footwear, or a control group (n = 15). At each data collection session, Doppler measurements of peak systolic blood flow velocity and cross-sectional area of the right popliteal vein were performed using a MySonoU6 ultrasound machine with a linear transducer (Samsung Medison). The differences were compared using Cohen’s d test to calculate effect size. Results With advancing phases of pregnancy, peak systolic velocity in the popliteal vein decreased significantly in the control group, whereas it increased significantly in the experimental group. No significant change in cross-sectional area was observed in any of the groups. Conclusions Findings in the experimental group demonstrated that wearing the footwear tested may prevent venous blood velocity from reducing during advanced phases of pregnancy. Nevertheless, there is a need for further investigation of the beneficial effect on venous flow of the footwear tested and its application.

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Effects of combined treatment with blood flow restriction and low-current electrical stimulation on muscle hypertrophy in rats

Journal of Applied Physiology ◽

10.1152/japplphysiol.00070.2019 ◽

2019 ◽

Vol 127 (5) ◽

pp. 1288-1296

Author(s):

Madoka Yoshikawa ◽

Takeshi Morifuji ◽

Tomohiro Matsumoto ◽

Noriaki Maeshige ◽

Minoru Tanaka ◽

...

Keyword(s):

Skeletal Muscle ◽

Blood Flow ◽

Electrical Stimulation ◽

Muscle Hypertrophy ◽

Combined Treatment ◽

Blood Flow Restriction ◽

Sectional Area ◽

Cross Sectional ◽

Flow Restriction ◽

Skeletal Muscle Hypertrophy

This study aimed to clarify the effects of a combined treatment comprising blood flow restriction and low-current electrical stimulation on skeletal muscle hypertrophy in rats. Male Wistar rats were divided into control (Cont), blood flow restriction (Bfr), electrical stimulation (Es), or Bfr with Es (Bfr + Es) groups. Pressure cuffs (80 mmHg) were placed around the thighs of Bfr and Bfr + Es rats. Low-current Es was applied to calf muscles in the Es and Bfr + Es rats. In experiment 1, a 1-day treatment regimen (5-min stimulation, followed by 5-min rest) was delivered four times to study the acute effects. In experiment 2, the same treatment regimen was delivered three times/wk for 8 wk. Body weight, muscle mass, changes in maximal isometric contraction, fiber cross-sectional area of the soleus muscle, expression of phosphorylated and total-ERK1/2, phosphorylated-rpS6 Ser235/236, phosphorylated and total Akt, and phosphorylated-rpS6 Ser240/244 were measured. Bfr and Es treatment alone failed to induce muscle hypertrophy and increase the expression of phosphorylated rpS6 Ser240/244. Combined Bfr + Es upregulated muscle mass, increased the fiber cross-sectional area, and increased phosphorylated rpS6 Ser240/244 expression and phosphorylated rpS6 Ser235/236 expression compared with controls. Combined treatment with Bfr and low-current Es can induce muscle hypertrophy via activation of two protein synthesis signaling pathways. This treatment should be introduced for older patients with sarcopenia and others with muscle weakness. NEW & NOTEWORTHY We investigated the acute and chronic effect of low-current electrical stimulation with blood flow restriction on skeletal muscle hypertrophy and the mechanisms controlling the hypertrophic response. Low-current electrical stimulation could not induce skeletal muscle hypertrophy, but a combination treatment did. Blood lactate and growth hormone levels were increased in the early response. Moreover, activation of ERK1/2 and mTOR pathways were observed in both the acute and chronic response, which contribute to muscle hypertrophy.

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Alterations of mature arterioles associated with chronically reduced blood flow

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1993.264.1.h40 ◽

1993 ◽

Vol 264 (1) ◽

pp. H40-H44 ◽

Cited By ~ 3

Author(s):

D. H. Wang ◽

R. L. Prewitt

Keyword(s):

Blood Flow ◽

Vascular Wall ◽

Cross Sectional Area ◽

Sectional Area ◽

Adaptive Responses ◽

Total Blood ◽

Cross Sectional ◽

Old Rats ◽

Total Blood Flow ◽

Autoregulatory Mechanism

Adaptive responses of mature arterioles were examined after a 38% reduction in total blood flow to the cremaster muscle produced by unilateral orchidectomy in 12-wk-old rats. Four weeks later, the muscle was smaller than the contralateral cremaster, which did not increase in size during this period. Measured by closed-circuit television microscopy, the internal diameters of first- through fourth-order arterioles (1A-4A) were smaller, but wall cross-sectional area was reduced only in 3As. The smaller diameter of the 1A in the orchidectomy muscle resulted in unchanged wall shear rate. As determined from the perfusion-fixed, microfilled cremaster muscles, the total length of the arcading arterioles and the number of 3As were not statistically different, but the total number of 4As was significantly reduced on the orchidectomy side. Therefore, chronic load reduction in a mature muscle resulted in reduced blood flow, decreased number of 4As, and smaller arteriolar internal diameters in the absence of net changes in vascular wall cross-sectional area. A local autoregulatory mechanism related to flow-induced shear stress is suggested as the mechanism mediating the changes.

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Effect of compression stockings on venous blood velocity and blood flow

Thrombosis and Haemostasis ◽

10.1160/th09-06-0365 ◽

2010 ◽

Vol 103 (01) ◽

pp. 138-144 ◽

Cited By ~ 18

Author(s):

Fadi Matta ◽

Abdo Yaekoub ◽

Syed Ahsan ◽

Aaref Badshah ◽

Fahad Younas ◽

...

Keyword(s):

Blood Flow ◽

Peak Velocity ◽

Venous Blood ◽

Blood Velocity ◽

Popliteal Vein ◽

Compression Stockings ◽

Mean Velocity ◽

Pulsed Wave Doppler ◽

Vein Diameter ◽

Time Average

SummaryThe effects of graduated compression stockings (GCS) on venous blood velocity have not been established. In healthy subjects, most investigations showed no effect on blood velocity, but mixed results have been reported. In this investigation we to test the hypothesis that popliteal blood velocity is increased by properly fitted GCS. Time average peak velocity in the popliteal vein, as well as time average mean velocity, vein diameter and mean volumetric flow were measured by pulsed wave Doppler ultrasound in 25 healthy male volunteers without compression stockings and repeated with fitted thigh-length compression stockings. Measurements were obtained while supine and while sitting at rest and during ankle exercise. Thigh-length GCS did not increase popliteal vein blood velocity, diameter, or volumetric blood flow while supine or sitting, with or without ankle exercise.

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