scholarly journals Some features of compression therapy for early forms of chronic venous diseases of the lower limbs

2019 ◽  
pp. 89-94 ◽  
Author(s):  
V. Yu. Bogachev ◽  
B. V. Boldin ◽  
N. R. Arkadan ◽  
V. N. Lobanov
Keyword(s):  
Class Ii ◽  
Calf Muscle ◽  
Lower Limbs ◽  
Class I ◽  
Venous Disease ◽  
Compression Garments ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Venous Diseases

The current compression garment selection guide is targeted at the earliest clinical stages of chronic venous disease (CVD) and assumes a priori that application of a higher class of compression improves the calf muscle pump function, which is the major mechanism promoting venous return from the lower limb to the heart.Objective of the study: to evaluate the calf muscle pump function in patients with the early forms of CVD using different classes of compression garments.Material and methods: A total of 30 patients (45 lower limbs) with Class 1 CVD (CEAP classification) were enrolled in the study. The calf muscle pump function was evaluated during wearing compression garments using remote cableless photoplethysmography of Bodytronic measurement system (Bauerfeind, Germany) with automatic data processing. The investigators measured venous refilling time (T0) and pump capacity (V0) in patients without compression garments and also in those wearing classes 0, I and II compression garments (RAL standard, Venotrain micro, Bauerfiend socks). All indicators were measured three times with an interval of 30 minutes. The final values of T0 and V0 were calculated as average.Results and discussion: when the indicators were measured without compression and with zero compression, T0 was 26.7 ± 1.2 sec and 25.4 ± 1.1 sec (p = 0.56); V0 - 8.6 ± 0.7% and 8.0 ± 0.4% (p = 0.47). When the calf muscle pump function indicators were measured using class I compression garments, its performance was improved. Thus, T0 and V0 (p <0.01) increased significantly to 38.9 ± 2.1 sec and 12.9 ± 1.4%, respectively. When the calf muscle pump function indicators were measured using class II compression garments, T0 and V0 were 38.1 ± 1.6 sec and 8.1 ± 0.6%. Thus, the use of class I compression garments significantly improved the calf muscle pump function in patients with early manifestations of CVD. The higher level of compression (class II) did not improve T0 and worsened V0. This fact can be explained by excessive compression of the muscular venous sinuses caused by wearing class 2 compression garments, which, apparently, worsened the propulsive ability of the calf pump.Conclusion: the use of class I compression garments is optimal for the management of hemodynamic disorders in patients with early forms of chronic venous diseases (C1 according to CEAP). The higher class of compression does not improve the hemodynamic parameters of the calf muscle pump.

The Influence of Minimal-Stretch and Elasticated Bandages on Calf Muscle Pump Function in Patients with Chronic Venous Disease

1999 ◽  
Vol 14 (1) ◽  
pp. 3-8 ◽  
Author(s):  
D. Yang ◽  
Y. K. Vandongen ◽  
M. C. Stacey
Keyword(s):  
Calf Muscle ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Venous Ulcers ◽  
Significant Difference ◽  
Venous Filling ◽  
University Department

Objective: To evaluate the influence of minimal-stretch and elasticated bandages on calf muscle pump function in patients with chronic venous disease. Design: An open, randomised, crossover study. Setting: University Department of Surgery, Fremantle Hospital, Perth, Australia. Subjects: Twenty patients with chronic venous disease and recently healed chronic venous ulcers. Method: Five different bandaging regimens were applied on each patient, and calf muscle pump function was assessed by using air plethysmography. Results: There was no significant difference in the venous filling index (VFI) and ejection fraction (EF) between the five different bandage regimens, and also no significant difference in four of the five bandage regimens over a 7-day period ( p>0.05). However, the VFI was significantly reduced and the EF was not significantly altered after the application of both elasticated and minimal-stretch bandages ( p<0.05, = p>0.05 respectively). Conclusion: All the bandage regimens used in this study have a similar influence on calf muscle pump function, and may therefore have a similar effect on the healing of chronic venous ulcers.

Quantitative Evaluation of Calf Muscle Pump Function after Deep Vein Thrombosis by Non-Invasive Venous Tests

1990 ◽  
Vol 5 (1) ◽  
pp. 51-59 ◽  
Author(s):  
S. Ohgi ◽  
K. Tanaka ◽  
T. Araki ◽  
K. Ito ◽  
H. Hara ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Quantitative Evaluation ◽  
Calf Muscle ◽  
Lower Limbs ◽  
Pump Function ◽  
Muscle Pump ◽  
Vein Thrombosis ◽  
Non Invasive ◽  
Calf Muscle Pump ◽  
Deep Vein

In order to quantitatively evaluate calf muscle pump function following deep vein thrombosis (DVT), expelled volume was investigated by strain gauge plethysmography (SPG). Thirty-six patients with 43 diseased lower limbs and nine healthy persons with 16 control limbs were studied. Of 43 diseased limbs, 20 symptomatic limbs were distinguished from 23 asymptomatic limbs by the presence of heaviness or aching. The following ***noninvasive parameters for the quantitative evaluation of calf muscle pump function, venous refilling time (VRT), venous outflow (VO), venous return (VR), and expelled volume (EV) were measured by SPG or photoplethysmography (DPG). Ambulatory venous pressure (AVP) was taken to represent the standard for calf muscle pump function. Using SPG, the EV, VR, and VRTs distinguished three groups (control, asymptomatic and symptomatic). Among seven indicators (EV, VR, VO, VRTs), EV had the highest correlation coefficient with the AVP ( r = +0.728). A positive EV was present in 85% of the symptomatic limbs, but in only 4% of the asymptomatic limbs. It is concluded that the EV is a useful non-invasive indicator for the quantitative evaluation of calf muscle pump function after deep vein thrombosis.

scholarly journals IP263 Effect of Total Knee Arthroplasty on Calf Muscle Pump Function

2017 ◽  
Vol 65 (6) ◽  
pp. 125S-126S
Author(s):  
Ryan N. Nolte ◽  
Andrew Mitchelson ◽  
Tiffany Whitaker ◽  
Douglas Hood ◽  
Kim Hodgson
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Calf Muscle ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Total Knee

Calf muscle pump failure in lower limb lymphoedema

2006 ◽  
Vol 21 (2) ◽  
pp. 96-99
Author(s):  
J H Parmar ◽  
M Aslam ◽  
N J Standfield
Keyword(s):  
Pump Power ◽  
Physical Disability ◽  
Interstitial Fluid ◽  
Calf Muscle ◽  
Lower Limbs ◽  
Pump Failure ◽  
Muscle Pump ◽  
Calf Muscle Pump ◽  
Good Consistency ◽  
Incurable Condition

Abnormal venous haemodynamics and poor calf muscle pump may play a role in lymphoedema by contributing to production of excess interstitial fluid. Using photoplethysmography (PPG), we compared haemodynamic characteristics between normal and lymphoedematous lower limbs. PPG was performed using an automated infrared-based system, while the patient performed 10 active dorsiflexions of the ankle. This gave values for venous refilling time and venous pump power. A total of 62 limbs (normal = 37; lymphoedematous = 25) were studied. Lymphoedematous limbs showed significantly decreased venous pump power and venous refilling time (s) than normal limbs (24.6±14.1 versus 45.4±16 and 23±15.2 versus >45, respectively; P<0.005 for all the results). The haemodynamic values measured in the normal group showed good consistency and reproducibility. These results were consistent with the previous literature and demonstrate an impaired venous system associated with the development of lymphoedema. Poor muscle pump power may reflect physical disability of the ankle joint to perform dorsiflexion. This factor should be considered when treating this incurable condition.

scholarly journals Reduced Calf Muscle Pump Function Is a Risk Factor for Venous Thromboembolism and Mortality

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 6-7
Author(s):  
Damon E. Houghton ◽  
Aneel A. Ashrani ◽  
Ramila Mehta ◽  
David O. Hodge ◽  
David Liedl ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Calf Muscle ◽  
Olmsted County ◽  
Pump Function ◽  
Muscle Pump ◽  
Vein Thrombosis ◽  
Calf Muscle Pump ◽  
The Mean ◽  
Deep Vein

Background: Venous return from the lower extremities is pumped upwards to the right side of the heart in a process that is facilitated by one-way valves and the venous muscle pump, of which the calf muscle pump is a major contributor1-3. Venous plethysmography can quantitatively assess calf pump function (CPF). The association between the CPF and venous thromboembolism (VTE) has not been investigated. Methods: Venous plethysmography (VP) data (strain gauge or air plethysmography) from the Mayo Clinic Vascular Lab database (1998-2015) of CPF (bilaterally reduced, unilaterally reduced, and bilateral normal) were examined in Olmsted County Residents. The Rochester Epidemiology Project (REP) captures the population of Olmsted County and contains demographic information, medical diagnoses, hospital admissions, and surgical procedures as well as validated VTE events and death. Patients with signs of obstructed outflow in either extremity on the venous plethysmography (a possible sign of acute or chronic deep vein thrombosis) study were excluded. Patients with a history of VTE diagnosed before the physiologic study were also excluded. If more than one measurement of calf muscle pump function was performed, only the first measurement was used. The primary outcome was a composite of any VTE, including proximal and distal deep vein thrombosis (DVT) and pulmonary embolism (PE). Results: 1703 Olmsted County residents had venous plethysmography studies performed. MN research authorization was denied in 64 patients and 107 were excluded for any documented VTE preceding index VP study. 1532 patients with recorded CPF (28% air and 72% strain gauge plethysmography) were studied: 591 (38.5%) had normal CPF, 353 (23.0%) had unilateral reduced CPF (rCPF), and 588 (38.3%) had bilateral rCPF. The mean age was 64.4 (SD 18.4), 68.9% were female, and the mean BMI was 29.5 (SD 6.4). Any VTE occurred in 87 patients (5.7%) after a mean follow up of 10.9 years (range 0-22.0 years). Isolated lower extremity DVT (excluding concurrent PE) occurred in 49 patients and PE+/-DVT occurred in 38 patients. Death occurred in 352 patients (23%). Bilateral rCPF compared to bilateral normal CPF was associated with VTE (p=0.007), DVT only (p=0.02) and death (p&lt;0.001) but not PE+/-DVT (p=0.13). Unilateral rCPF compared to bilateral normal CPF was not associated with VTE, but was associated with death (p&lt;0.001). Kaplan-Meier curves for VTE and death are shown in Figure 1. The hazard ratio for bilateral rCPF compared to bilateral normal CPF for VTE was 2.0 (95% CI 1.2-3.4) and for DVT only was 2.2 (95% CI 1.1-4.2). A sensitivity analysis for the main outcome of VTE did not show significant interaction based on the type of plethysmography (strain vs. air), by age stratified at 65 years, sex, or BMI stratified at 30 (p&gt;0.1 for each comparison). Conclusion: In this population-based study of Olmsted County residents with no prior VTE, rCPF function as measured by venous plethysmography is associated with increased risk for VTE, particularly lower extremity proximal DVT. More research is required to understand what additional measures of venous physiology influence these findings and whether CPF could be used in VTE risk stratification. Disclosures No relevant conflicts of interest to declare.

The Effect of Lower Limb Cast Immobilization on Calf Muscle Pump Function

2014 ◽  
Vol 35 (5) ◽  
pp. 429-433 ◽  
Author(s):  
Ben A. Hickey ◽  
Amy Morgan ◽  
Neil Pugh ◽  
Anthony Perera
Keyword(s):  
Lower Limb ◽  
Calf Muscle ◽  
Cast Immobilization ◽  
Pump Function ◽  
Muscle Pump ◽  
Calf Muscle Pump
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