Limited range of motion is a significant factor in venous ulceration

Back, Thomas L.; Padberg, Frank T.; Araki, Clifford T.; Thompson, Peter; Hobson, Robert W.

doi:10.1016/s0741-5214(95)70030-7

Cited by 154 publications

(127 citation statements)

References 12 publications

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“…Comprehensive evaluation and therapeutic management of these patients are less than expected [12][13][14][15] . The tibiotarsal joint mobility combined with venous valvular competence, working simultaneously, is the engine that drives the return of venous blood to the heart via anatomical relations between nerves, muscles, tendons, joint capsules, ligaments and cartilages 16 . We observed that the reduction of ROM is an aggravating factor for CVI of lower limbs, because total and permanent ankle ankylosis makes patients incurable by limiting, or even annulling, the most important action of the pulse-aspiration pump of lower limbs, which is the calf muscle 17 .…”

Section: Discussionmentioning

confidence: 99%

Avaliação das limitações de úlcera venosa em membros inferiores

Lopes

Figueiredo²,

Ávila

et al. 2013

J. vasc. bras.

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Background: The chronic venous insufficiency (CVI) has a considerable socioeconomic impact in Western countries due to its high prevalence, research and treatment cost, and loss of workdays. The Short Form Health Survey (SF-36) questionnaire, the analysis of muscular activation and mobility of the tibiotarsal joint are instruments used for CVI evaluation. Objective: To assess osteomuscular limitations and changes in the quality of life of patients with venous ulcers in lower limbs. Methods: Ten patients with ulcers classified using CEAP (Clinical, Etiological, Anatomical, and Pathophysiological) classification were evaluated. Six of them answered the SF-36 questionnaire and the pain analogue scale, and underwent goniometry, muscular strength evaluation and electromyography. Results: The mean age of studied subjects was 67.4 (±11.7), and 70% of them were female. Results showed no statistically significant correlation between pain, range of motion (ROM), muscular strength, electromyography (EMG), and the lesion size. However, results showed a correlation between the psychological profile on SF-36 questionnaire and the domain of motor activities, as well as between psychological profile and social activities, and between psychological profile and perception of itself. The electromyographic evaluation of studied muscles also showed a significant difference. Conclusion: The presence of venous ulcers in lower limbs can generate limitations and changes in these patients' quality of life. The psychosocial aspect showed preponderance over the motor one, increasing restrictions in daily activities.

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Section: Discussionmentioning

confidence: 99%

Avaliação das limitações de úlcera venosa em membros inferiores

Lopes

Figueiredo²,

Ávila

et al. 2013

J. vasc. bras.

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“…Back et al stated that a normal walking motion is required for activation of the calf muscular pump and this requires 90 degrees of dorsiflexion [78]. It has been found that exercise program twice a week increased the angle of dorsiflexion and plantar flexion in those with CVI [79].…”

Section: Exercisementioning

confidence: 99%

Conservative Management of Chronic Venous Insufficiency

Özdemir¹,

Sürmeli²

2017

Clinical Physical Therapy

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Chronic venous insufficiency (CVI) is a common medical condition with major socioeconomic impact. Prevalence in adult population is estimated to be 5-30%. Its pathology is based on venous hypertension on the lower extremities. This results in edema, subcutaneous fibrosis, pigmentation, chronic pain and ulceration. The severity of chronic venous disease is closely related to the magnitude of venous hypertension. Treatment options for CVI include medical, interventional, surgical and physical treatments. The initial management of CVI involves conservative approaches to reduce symptoms and prevent development of secondary complications and progression of disease. It includes the elevation of the limb together with the supportive methods, pharmacotherapy and structured exercise program, as well as complex decongestive physiotherapy (CDP), intermittent pneumatic compression (IPC), compression stocking (CS), patient education and kinesio tape. CVI is a chronic disease that needs a lifelong care. In this review, we present a discussion about pathophysiology and risk factors for CVI development and conservative treatment options.

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“…Calf muscle pump dysfunction might be caused by weakness of calf muscles but may also be related to decreased range of motion around the ankle joint during walking and other movements [30,75,78,98], neuropathy, muscle denervation or muscle atrophy, or gait abnormalities [29,36,43].…”

Section: Impairment Of Calf Muscle Pump and Functional Capacitymentioning

confidence: 99%

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

Crisóstomo¹,

Armada-da-Silva²

2017

Clinical Physical Therapy

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Chronic venous disease (CVD) is a chronic condition that is associated with venous hypertension, vein's valves damage, venous obstruction, and calf muscle pump impairment. This blood circulatory condition is also characterized by important inflammatory changes affecting the skin, the subcutaneous tissue and the muscles, which are probably triggered by blood stasis and venous edema. With disease progression, severe ulcerative skin damage might occur, which when present represent the more severe stage of this condition. CVD has a significant economic, social and health impact, mostly due to raised morbidity and chronicity.The treatment of patients with CVD might focus on both the symptoms and secondary changes of the disease, such as edema, skin and subcutaneous changes or ulcers.Usually, initial treatment of CVD patients involves a non-invasive, conservative treatment to reduce symptoms, treat secondary changes, and help prevent the development of secondary complications and the progression of the disease. Complementary, some interventional or surgical treatments can be undertaken.There are several conservative treatments to treat and prevent complications associated with CVD that have been described in the literature, like manual lymphatic drainage (MLD) and compression, physical exercise, intermittent pneumatic pressure, kinesio taping, electrical muscle stimulation, transcutaneous electrical nerve stimulation, hydrotherapy, and health education. Most of these techniques are complementary to compression therapy or pharmacological treatment. This chapter will address the role of physical therapists in the management of CVD. The chapter will begin by reviewing the basic physiopathology of CVD, including the role of calf muscle pump. The CEAP classification system and the chronic venous severity score will be presented, as these are main tools for clinical assessment of CVD severity. In the remainder of the chapter will address the physiological effects and recommendations for treating CVD of MLD, based on our clinical experience and own research.

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Limited range of motion is a significant factor in venous ulceration

Abstract: Limbs with CVI have a limited ankle ROM that decreases with increasing severity of clinical symptoms. This decreased ROM is associated with, and may contribute to, poor calf pump function.

Cited by 154 publications

References 12 publications

Avaliação das limitações de úlcera venosa em membros inferiores

Avaliação das limitações de úlcera venosa em membros inferiores

Conservative Management of Chronic Venous Insufficiency

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

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