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Cao Y, He J, Chen X, Jing L, Qiu J, Geng Y, Chen F, Sun G, Ji X. The impact of ankle movements on venous return flow: A comparative study. Phlebology 2024:2683555241264914. [PMID: 39028225 DOI: 10.1177/02683555241264914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
OBJECTIVE To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity. METHODS 28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion. RESULTS In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences (p < .01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement (p > .05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow. CONCLUSION The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated.
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Affiliation(s)
- Yun Cao
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - JinFeng He
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xufeng Chen
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lei Jing
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - JiaWen Qiu
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - YuJuan Geng
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Feng Chen
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - GuoZhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - XueLi Ji
- Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Sakai K, Takahira N, Tsuda K, Akamine A. A novel device for lower leg intermittent pneumatic compression synchronized with active ankle exercise for prevention of deep vein thrombosis. Phlebology 2022; 37:507-515. [DOI: 10.1177/02683555221089618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective Intermittent pneumatic compression devices (IPCDs) and active ankle exercises have been shown to be efficacious in preventing venous thromboembolism (VTE) by increasing venous flow velocity and volume. However, IPCDs are expensive and require electricity; therefore, they cannot be used in the event of power loss. We developed a non-powered device that provides lower leg intermittent pneumatic compression synchronized with AAEs (LISA) and compared its efficacy with AAEs alone in increasing the peak velocity in the femoral vein. Methods The study population consisted of 20 healthy younger men and 20 healthy older men who performed AAE every 2 s in a sitting posture under four conditions: AAE with LISA (AAE+LISA), AAE alone (AAE), AAE with IPCD, and AAE with a graduated compression stocking. Results The PVs under all conditions were significantly higher than those at rest. The PVs in the AAE+LISA condition were significantly higher than those in the AAE alone condition in both younger and older groups (both p < .001). Conclusions AAE with LISA significantly increased the PV, suggesting that LISA might be useful for preventing DVT.
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Affiliation(s)
- Kenta Sakai
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Rehabilitation Center, St Marianna University School of Medicine, Kawasaki-shi, Japan
| | - Naonobu Takahira
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Department of Orthopaedic Surgery, Kitasato University Graduate School of Medical Sciences, Sagamihara-shi, Japan
- Physical Therapy Course, Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara-shi, Japan
| | - Kouji Tsuda
- Sensory and Motor Control, Graduate School of Medical Sciences, Kitasato University, Sagamihara-shi, Japan
- Department of Hygiene and Public Health, Osaka Medical and Pharmaceutical University, Takatsuki-shi, Japan
| | - Akihiko Akamine
- Department of Pharmacy, Kitasato University Hospital, Sagamihara-shi, Japan
- Orthopedic Surgery, Clinical Medicine, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan
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Sakai K, Takahira N, Tsuda K, Akamine A. Effects of intermittent pneumatic compression on femoral vein peak venous velocity during active ankle exercise. J Orthop Surg (Hong Kong) 2021; 29:2309499021998105. [PMID: 33641535 DOI: 10.1177/2309499021998105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The risk of developing deep vein thrombosis (DVT) is high even after the period of bed rest following major general surgery including total joint arthroplasty (TJA). Mobile intermittent pneumatic compression (IPC) devices allow the application of IPC during postoperative exercise. Although ambulation included ankle movement, no reports have been made regarding the effects of IPC during exercise, including active ankle exercise (AAE), on venous flow. This study was performed to examine whether using a mobile IPC device can effectively augment the AAE-induced increase in peak velocity (PV). METHODS PV was measured by Doppler ultrasonography in the superficial femoral vein at rest, during AAE alone, during IPC alone, and during AAE with IPC in 20 healthy subjects in the sitting position. PV in AAE with IPC was measured with a mobile IPC device during AAE in the strong compression phase. AAE was interrupted from the end of the strong compression phase to minimize lower limb fatigue. RESULTS AAE with IPC (76.2 cm/s [95%CI, 69.0-83.4]) resulted in a significant increase in PV compared to either AAE or IPC alone (47.1 cm/s [95%CI, 38.7-55.6], p < 0.001 and 48.1 cm/s [95%CI, 43.7-52.4], p < 0.001, respectively). DISCUSSION Reduced calf muscle pump activity due to the decline in ambulation ability reduced venous flow. Therefore, use of a mobile IPC device during postoperative rehabilitation in hospital and activity including self-training in an inpatient ward may promote venous flow compared to postoperative exercise without IPC. CONCLUSION Use of a mobile IPC device significantly increased the PV during AAE, and simultaneous AAE with IPC could be useful evidence for the prevention of DVT in clinical settings, including after TJA.
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Affiliation(s)
- Kenta Sakai
- Sensory and Motor Control, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan.,Rehabilitation Center, St Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan
| | - Naonobu Takahira
- Sensory and Motor Control, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan.,Department of Orthopaedic Surgery, 38088Kitasato University Graduate School of Medical Sciences, Sagamihara-shi, Kanagawa, Japan.,Department of Rehabilitation, 38088Kitasato University School of Allied Health Sciences, Sagamihara-shi, Kanagawa, Japan
| | - Kouji Tsuda
- Sensory and Motor Control, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan.,Department of Hygiene and Public Health, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Akihiko Akamine
- Department of Pharmacy, Kitasato University Hospital, Sagamihara-shi, Kanagawa, Japan.,Orthopedic Surgery, Clinical Medicine, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan
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Wattanapanyawech J, Thaveeratitham P. The Effect of Breathing Cycles Program on Heart Rate and Sleep Parameters in Healthy Young Adults. SLEEP MEDICINE RESEARCH 2020. [DOI: 10.17241/smr.2020.00668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tsuda K, Takahira N, Ejiri M, Sakai K, Sakamoto M, Akamine A. Effect of resistance of the exercise band on the peak femoral vein velocity during active ankle flexion. Phlebology 2019; 35:176-183. [DOI: 10.1177/0268355519865164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To examine the resistance effect of using an exercise band on the lower extremity venous velocity during active ankle flexion. Methods Twenty healthy young adult men performed active ankle flexion every 2 s either with no band or with two exercise bands, marked red and silver in the order of increasing tension. They held the band in its natural length with an elbow in extension and an ankle in maximal dorsiflexion at initiation of each active plantar flexion in each posture. The peak velocity in the right superficial femoral vein was measured in each condition. Results Holm’s multiple comparisons revealed significant increases in the mean (individual 95% confidence intervals) peak velocities (cm/s) with no, red, and silver bands (35.8 (28.9–42.7), 46.5 (38.8–54.3), and 56.9 (47.0–66.8), respectively, in the sitting posture, and 50.7 (39.2–62.3), 60.7 (46.8–74.6), and 69.0 (55.3–82.7), respectively, in the supine posture; all p < 0.01). Conclusion Resistance with the exercise bands efficiently enhanced the femoral venous velocity during active ankle plantar flexion.
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Affiliation(s)
- Kouji Tsuda
- Sensory and Motor Control, Kitasato University, Kanagawa, Japan
| | - Naonobu Takahira
- Sensory and Motor Control, Kitasato University, Kanagawa, Japan
- Department of Rehabilitation, Kitasato University, Kanagawa, Japan
| | - Motoki Ejiri
- Department of Rehabilitation, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Kenta Sakai
- Sensory and Motor Control, Kitasato University, Kanagawa, Japan
| | - Miki Sakamoto
- Department of Rehabilitation, Kitasato University, Kanagawa, Japan
| | - Akihiko Akamine
- Department of Pharmacy, Kitasato University Hospital, Kanagawa, Japan
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Aufwerber S, Praxitelous P, Edman G, Silbernagel KG, Ackermann PW. Increased risk of deep venous thrombosis in patients with poor ankle dorsiflexion after lower limb immobilization. OTA Int 2019; 2:e038. [PMID: 37662835 PMCID: PMC10473320 DOI: 10.1097/oi9.0000000000000038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 04/10/2019] [Indexed: 09/05/2023]
Abstract
Objective Many trauma patients are at risk of pulmonary embolism due to unrecognized deep vein thrombosis (DVT). Restricted ankle dorsiflexion (AD) range of motion during leg immobilization is known to cause reduced venous blood flow. The aim of the present study was to assess whether AD at plaster cast removal is related to the incidence of DVT and to patient outcome. Design Prospective observational cohort study. Setting Level 1 Trauma Center. Patients A total of 124 patients (97 men, 27 women; mean age 40.3 years) with plaster cast leg immobilization after surgical repair of Achilles tendon rupture were assessed. Main outcome measures At 2 weeks postoperatively, assessments of AD and the incidence of DVT using compression duplex ultrasound were performed with observers blinded to patient grouping. Patients were dichotomized into 2 groups; poor or good AD, according to the mean AD, -7°. At 3- and 12 months patient-reported outcome was examined using validated questionnaires (ATRS and FAOS), and functional outcome using the heel-rise test. Results Patients with poor AD sustained 42% DVTs, while patients with good AD exhibited a DVT-rate of 23% (P = .036). Logistic regression analysis corroborated this finding (OR = 2.62, P = .036; 95% CI = 1.06-6.44). AD was not linked to any long-term functional or patient-reported outcome. Conclusions Reduced AD after plaster cast removal is associated with a higher risk of DVT. The results of this observational study warrant further prospective studies to confirm the effects of ankle dorsiflexion on the risk of developing venous thromboses.Level of evidence: II.
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Affiliation(s)
- Susanna Aufwerber
- Department of Molecular Medicine and Surgery, Karolinska Institutet
- Functional Area Occupational therapy and Physiotherapy, Allied Health Professionals Function
| | - Praxitelis Praxitelous
- Department of Molecular Medicine and Surgery, Karolinska Institutet
- Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm
| | - Gunnar Edman
- Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden
| | | | - Paul W Ackermann
- Department of Molecular Medicine and Surgery, Karolinska Institutet
- Department of Orthopedic Surgery, Karolinska University Hospital, Stockholm
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Kiss G, Faludi B, Szilágyi B, Makai A, Velényi A, Ács P, Tardi P, Pallag A, Bors V, Sekk P, Járomi M. Effect of Active and Passive Mechanical Thromboprophylaxis and Consensual Effect on the Venous Blood Flow Velocity Among Hemiparetic Patients. Clin Appl Thromb Hemost 2019; 25:1076029619832111. [PMID: 30813755 PMCID: PMC6714927 DOI: 10.1177/1076029619832111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Our aim was to measure the venous blood flow velocity (VBFV) in case of hemiparetic patients, after passive and active thromboembolic methods, as well as the consensual effect in the hemiparetic limb following the active venous exercises in the healthy limb. We examined 215 patients, with the median age of 58.0 (55.0-63.0) years. The VBFV was measured with a HADECO BIDOP ES-100 V II type Doppler ultrasound device, using an 8 MHz head, on the femoral vein at the level of the hip joint. For statistical analysis, SPSS version 22 was used. After passive movement, on the hemiparetic side, compared to the value in resting state, the VBFV significantly (12.6; 11.6-13.5 cm/s; P < .001) increased. Following active venous exercises performed on the healthy side, the VBFV significantly (18.0; 15.6-19.6 cm/s; P < .001) increased compared to the value in resting state. Following the active venous exercises performed on the healthy side, the VBFV measured on the hemiparetic side (consensual effect) was significantly (15.1 [14.1-16.5] cm/s; P < .001) higher than the value on the hemiparetic side in resting state. Active and passive mechanical thromboprophylaxis methods can be effective. Movements of the healthy limb significantly increase the VBFV in the inactive limb, and patients can perform it themselves several times a day.
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Affiliation(s)
- Gabriella Kiss
- 1 Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
| | - Béla Faludi
- 2 Neurology Clinic, University of Pécs Medical School, Pécs, Hungary
| | - Brigitta Szilágyi
- 1 Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary.,3 Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Alexandra Makai
- 3 Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Anita Velényi
- 4 Department of Neurosurgery, University of Pécs Clinic Centre, Pécs, Hungary
| | - Pongrác Ács
- 1 Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
| | - Péter Tardi
- 1 Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
| | - Adrienn Pallag
- 4 Department of Neurosurgery, University of Pécs Clinic Centre, Pécs, Hungary
| | - Viktória Bors
- 4 Department of Neurosurgery, University of Pécs Clinic Centre, Pécs, Hungary
| | | | - Melinda Járomi
- 1 Faculty of Health Sciences, Institute of Physiotherapy and Sport Science, University of Pécs, Pécs, Hungary
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Versteeg HH, Rodger M. HAPPY NEW CAREER!! Thromb Res 2018; 162:87. [DOI: 10.1016/j.thromres.2018.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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