Kenta Sakai1,2, Naonobu Takahira1,3,4, Kouji Tsuda1,5, Akihiko Akamine6,7. 1. Sensory and Motor Control, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara-shi, Kanagawa, Japan. 2. Rehabilitation Center, St Marianna University School of Medicine, Kawasaki-shi, Kanagawa, Japan. 3. Department of Orthopaedic Surgery, 38088Kitasato University Graduate School of Medical Sciences, Sagamihara-shi, Kanagawa, Japan. 4. Department of Rehabilitation, 38088Kitasato University School of Allied Health Sciences, Sagamihara-shi, Kanagawa, Japan. 5. Department of Hygiene and Public Health, Osaka Medical College, Takatsuki, Osaka, Japan. 6. Department of Pharmacy, Kitasato University Hospital, Sagamihara-shi, Kanagawa, Japan. 7. Orthopedic Surgery, Clinical Medicine, Graduate 38088School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
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.
RCT Entities:
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.
Entities:
Keywords:
active ankle exercise; blood flow velocity; deep vein thrombosis; mobile intermittent pneumatic compression device; physical prophylaxis