Neuromuscular electrical stimulation for the prevention of venous thromboembolism

Hajibandeh, Shahab; Hajibandeh, Shahin; Antoniou, George Α.; Scurr, J.R.H.; Torella, Francesco

doi:10.1002/14651858.cd011764

Cited by 12 publications

(12 citation statements)

References 23 publications

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“…In this study, a total of 3,116 orthopedic surgery patients in 7 articles were screened for a meta-analysis, and the study results showed that in the random effect mode, the OR of DVT was [0.59, 95% CI: (0.34, 1.03)] when elastic stockings were used versus no elastic stockings, but the statistic value was Z=1.84, P=0.09, suggesting that the difference was not statistically significant; that is, elastic stockings had no significant preventive effect on DVT. This is different from meta-analyses performed by Sachdeva et al (17) and Hajibandeh et al (18), and may be due to the fact that we focused on patients after orthopedic surgery, whereas the subjects of the other meta-analysis were patients with different surgeries. Our result suggests that for patients undergoing orthopedic surgery, it is not enough to use elastic stockings alone for DVT prevention, and it needs to be performed in combination with other methods such as anticoagulant drugs, pneumatic compression, etc., in order to achieve better results.…”

Section: Discussioncontrasting

confidence: 58%

A systematic review and meta-analysis of elastic stockings for prevention of thrombosis after orthopedic surgery

et al. 2021

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Background: To investigate the preventive effect of elastic stockings on deep vein thrombosis (DVT) after orthopedic surgery by literature search and meta-analysis.Methods: PubMed, Embase and Cochrane were selected as the search database platforms to search the literature of randomized controlled trials related to elastic stockings and DVT published from 2008 to date.Revman 5.3.5 software was used for statistical analysis of the data to obtain forest and funnel plots.Results: In this study, 90 studies were initially screened and 7 were finally included, covering a total of 3,116 patients. Meta-analysis showed that the 7 studies had statistical heterogeneity (I 2 =32%, P=0.18), so a random effect model was used. The obtained statistic was [odds ratio (OR) =0.59, 95% confidence interval (CI): (0.34, 1.03)], the statistical effect size was Z=1.84, P=0.07, and the difference was not statistically significant, so a stepwise sensitivity analysis was performed by the exclusion method. One study was excluded, and the remaining 6 showed homogeneity (I 2 =0%, P=0.46). They were analyzed by subgroup according to the type of operation: ankle surgery or hip and knee arthroplasty. The internal literatures of each subgroup were homogeneous: ankle surgery subgroup (I 2 =0%, P=0.43), hip and knee arthroplasty subgroup (I 2 =0%, P=0.88). Therefore, fixed effect mode analysis was used, and the effect size of elastic stockings after ankle surgery was Z=3.65, P=0.0003, while the effect size of elastic stockings in the hip and knee arthroplasty subgroup was Z=1.23, P=0.22.Discussion: Elastic stockings had an obvious preventive effect on DVT in patients undergoing ankle surgery, but not in patients undergoing lumbar, knee or spinal surgery. It is necessary to combine anticoagulant drugs and other physical therapies to prevent DVT.

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Section: Discussioncontrasting

confidence: 58%

A systematic review and meta-analysis of elastic stockings for prevention of thrombosis after orthopedic surgery

et al. 2021

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“…PV is a measurement parameter used to measure the effectiveness of the DVT prevention methods. Increases in PV are seen to be beneficial for the prevention of DVT [ 24 , 25 , 26 ]. The blood flow response to the intervention (NMES, voluntary contraction) is clearly distinguishable from the waveform.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Hemodynamic Performance of Two Neuromuscular Electrical Stimulation Devices Applied to the Lower Limb

Avazzadeh

O'Farrell

Flaherty

et al. 2020

JPM

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Currently, 1% of the population of the Western world suffers from venous leg ulcers as a result of chronic venous insufficiency. Current treatment involves the use of moist wound healing, compression bandages, and intermittent pneumatic compression. Neuromuscular electrical stimulation is a novel potential new therapeutic method for the promotion of increased lower limb hemodynamics. The aim of this study was to measure the hemodynamic changes in the lower limb with the use of two neuromuscular electrical stimulation devices. Twelve healthy volunteers received two neuromuscular stimulation device interventions. The GekoTM and National University of Ireland (NUI) Galway neuromuscular electrical stimulation devices were randomized between dominant and non-dominant legs. Hemodynamic measurements of peak venous velocity (cm/s), the time average mean velocity (TAMEAN) (cm/s), and ejected volume (mL) of blood were recorded. Peak venous velocity was significantly increased by the GekoTM and the NUI Galway device compared to baseline blood flow (p < 0.0001), while only the voluntary contraction produced significant increases in TAMEAN and ejected volume (both p < 0.05). Neuromuscular muscular electrical stimulation can produce adequate increases in lower limb hemodynamics sufficient to prevent venous stasis. Greater use of neuromuscular stimulation devices could be considered in the treatment of conditions related to chronic venous insufficiency but requires further research.

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“…In concordance with this recommendation, more recent focus on early postoperative range of motion and ambulation has been investigated. Studies that initially focused on the use of continuous passive motion as well as neuromuscular electric stimulation failed to show a significant decrease in the incidence of VTE [12,13].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Bladder Catheterization on Ambulation and Venous Thromboembolism Following Total Knee Arthroplasty: An Institutional Analysis

Gold

Garbarino

Anis

et al. 2020

The Journal of Arthroplasty

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Background: Although intermittent catheters are immediately removed, indwelling catheterization may lead to decreased ambulation and participation in physical therapy, critical components to post-total knee arthroplasty (TKA) management. Therefore, this study aimed to compare the effect of catheterization treatments on (1) postoperative ambulation distances, (2) deep vein thromboses (DVTs), and (3) pulmonary emboli (PEs) following TKA. Methods: A total of 9123 prospectively collected primary TKA patients were assessed based on postoperative catheter status. Patient demographics, Charlson Comorbidity Indices, body mass indices, DVT prophylaxes, first ambulation distances, DVTs, and PEs were collected at approximately mean 12 months of follow-up. Univariate and multivariate analyses were performed with independent t-tests and multiple linear regression models in order to compare catheterization techniques. Results: There were 1193 patients who had urinary retention and treated with either indwelling only (62%, n ¼ 734), both indwelling and intermittent catheterizations (13%, n ¼ 160), or intermittent only (25%, n ¼ 299). Multivariate analyses found that indwelling catheter-only use had an 11% decrease in ambulation distance (P < .001). Additionally, the indwelling catheterization-only group was found to be at increased risk of DVTs (odds ratio 2.605, P < .001), even after controlling for DVT prophylaxes (odds ratio 2.807, P < .001). Conclusion:This study showed that the use of an indwelling catheter for treatment of urinary retention significantly decreased TKA patient ambulation distance and subsequently increased the risk for DVTs. This information is important as we would recommend the treatment with intermittent catheterization rather than indwelling catheters to decrease the risk of immobilization and postoperative DVTs.

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Neuromuscular electrical stimulation for the prevention of venous thromboembolism

Cited by 12 publications

References 23 publications

A systematic review and meta-analysis of elastic stockings for prevention of thrombosis after orthopedic surgery

A systematic review and meta-analysis of elastic stockings for prevention of thrombosis after orthopedic surgery

Comparison of the Hemodynamic Performance of Two Neuromuscular Electrical Stimulation Devices Applied to the Lower Limb

The Effect of Bladder Catheterization on Ambulation and Venous Thromboembolism Following Total Knee Arthroplasty: An Institutional Analysis

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