A randomised controlled trial of neuromuscular stimulation in non-operative venous disease improves clinical and symptomatic status

Abstract

Background This randomised controlled trial investigates the dosing effect of neuromuscular electrical stimulation (NMES) in patients with chronic venous disease (CVD). Methods Seventy-six patients with CEAP C3-C5 were randomised to Group A (no NMES), B (30 minutes of NMES daily) or C (60 minutes of NMES daily). Primary outcome was percentage change in Femoral Vein Time Averaged Mean Velocity (TAMV) at 6 weeks. Clinical severity scores, disease-specific and generic quality of life (QoL) were assessed. Results Seventy-six patients were recruited - mean age 60.8 (SD14.4) and 47:29 male. Six patients lost to follow-up. Percentage change in TAMV (p<0.001) was significantly increased in Groups B and C. Aberdeen Varicose Veins Questionnaire Score (-6.9, p=0.029) and Venous Clinical Severity Score (-4, p-0.003) improved in Group C, and worsened in Group A (+1, p=0.025). Conclusions Daily NMES usage increases flow parameters, with twice daily usage improving QoL and clinical severity at 6 weeks in CVD patients.

Effects of combining electrical stimulation of the calf and thigh muscles in patients with osteoarthritis of the knee: protocol for a double-blind, randomised, sham-controlled trial

“…The device consists of electrodes for quadriceps stimulation and footplate electrodes for stimulation of the calf and foot. The footplate has previously been investigated for its influence on peripheral artery disease and chronic venous disease and was found to significantly improve circulation and walking distance 32 33. These investigations did not include quadriceps stimulation and there have been no investigations into the effects of the device for KOA.…”

The effect of an eight-week treatment program using a novel foot neuromuscular electrical stimulator (NMES) on physical function and leg pain, symptoms and blood flow in community dwelling older adults: a randomized sham-controlled trial

“…Subsequent studies of NMES using the Revitive footplate in individuals with peripheral artery disease showed significant increases in blood volume flow and time-adjusted mean blood velocity during device use; this was associated with amelioration of claudication symptoms during exercise, increased exercise capacity and improved diseasespecific quality of life (Babber 2020). Similarly, studies in patients with chronic venous disease demonstrate that NMES significantly increases venous flow parameters and ameliorates the effect of orthostasis on fluid accumulation during use (Ravikumar 2017, Ravikumar 2021).…”

The effect of an 8-week treatment program using a novel foot neuromuscular electrical stimulator on physical function, leg pain, leg symptoms, and leg blood flow in community-dwelling older adults: a randomized sham-controlled trial

“…Subsequent studies of NMES using the Revitive footplate in individuals with peripheral artery disease showed significant increases in blood volume flow and time-adjusted mean blood velocity during device use; this was associated with amelioration of claudication symptoms during exercise, increased exercise capacity, and improved disease-specific quality of life [ 24 ]. Similarly, studies in patients with chronic venous disease demonstrate that NMES significantly increases venous flow parameters and ameliorates the effect of orthostasis on fluid accumulation during use [ 25 , 26 ].…”