Neuropathy and Gait Disturbances in Patients With Venous Disease: A Pilot Study

Newland, Meggan; Patel, Asha R.; Prieto, L. M.; Boulton, Andrew J.M.; Pacheco, Miriam; Kirsner, Robert S.

doi:10.1001/archdermatol.2009.14

Cited by 14 publications

(11 citation statements)

References 5 publications

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“…This results in loss of ankle joint movement which negatively affects the calf pump. Gait training and improving ankle range of motion may be helpful as might be medications for the neuropathy that occurs in these patients 57. Clinicians should watch clients walk and encourage them to bend the ankle and foot in a normal motion.…”

Section: Discussionmentioning

confidence: 99%

Injection-Related Venous Disease and Walking Mobility

Pieper

Templin

Kirsner

et al. 2010

Journal of Addictive Diseases

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Injection users are at risk for vascular injuries resulting in chronic venous disease (CVD). We examined walking mobility in relation to CVD for 713 persons in methadone treatment. We used a cross-sectional, comparative design, stratified on age, sex, ethnicity, and drug use. CVD was present in 92.3% of participants. The structural equation model supported the causal link between leg injection and CVD (.40, P<.001). The worse the mobility, the greater was the CVD classification (-.21, P<.001). CVD had an indirect effect on mobility through pain. CVD and pain need to be considered when assessing mobility in illicit drug users.

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Section: Discussionmentioning

confidence: 99%

Injection-Related Venous Disease and Walking Mobility

Pieper

Templin

Kirsner

et al. 2010

Journal of Addictive Diseases

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“…Patients with venous ulcers may also have an abnormal walking motion. Newland et al 65 evaluated the gait of patients with venous disease. Using pedal pressure measurements to identify differences compared with controls, foot pressures were measured as a surrogate method to study gait.…”

Section: Gait Abnormalitiesmentioning

confidence: 99%

“…Patients with chronic venous insufficiency were observed to have lower total foot pressures. The distribution of pressure was also altered, with chronic venous insufficiency patients having higher midfoot and lower big toe pressures 65 . Additionally, patients with venous ulcers have also been shown to take fewer steps per week compared with controls 66 …”

Section: Gait Abnormalitiesmentioning

confidence: 99%

Venous ulcers: A reappraisal analyzing the effects of neuropathy, muscle involvement, and range of motion upon gait and calf muscle function

Shiman

Pieper

Templin

et al. 2009

Wound Repair Regeneration

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Chronic venous insufficiency is a complex disease that can result in severe sequelae including venous ulceration. Though the exact progression from chronic venous insufficiency to venous ulcer remains unclear, the high cost and burden of this disease on patients and society is quite clear. Sustained ambulatory venous pressures or venous hypertension plays an integral role in the development of venous ulceration and involves the failure of the calf muscle pump system. Standard of care involves compression therapy to assist the calf muscle pump. However, several cofactors may contribute to or exacerbate this disease and understanding their impact may provide insight into new treatment modalities. Nerve involvement, which may result in neuropathic pain and muscle dysfunction, alterations in mobility and a decrease in range of motion may lead to gait alterations all affecting calf muscle pump function. In this paper, we analyze these cofactors and discuss possible treatment options to target them. Physicians treating this disease should be aware of the numerous factors involved in its development. Exploring new treatment options may 1 day lessen the burden and suffering caused by venous insufficiency.

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“…According to self-reports, functional status is diminished in these patients [36,39] also because of some physical dysfunctions, like abnormalities in gait [45], impaired balance, peripheral neuropathy [43,46] weak leg muscles (plantar flexion and dorsiflexion muscles) [29,30,45], or diminished ankle range of motion [10,30,47]. These dysfunctions are also associated with impaired muscle pump function in the lower extremity [43], an important risk factor for venous ulceration [48].…”

Section: Functional and Hrql Implications Of Cvdmentioning

confidence: 99%

“…These functional alterations, specially the decreased strength of the calf muscles and reduced ambulation, contribute to venous hypertension [30,43,46,47,57,98]. Dysfunction of the muscle pumps leads to venous blood not being effectively emptied out of the distal extremity [30].…”

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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Neuropathy and Gait Disturbances in Patients With Venous Disease: A Pilot Study

Cited by 14 publications

References 5 publications

Injection-Related Venous Disease and Walking Mobility

Injection-Related Venous Disease and Walking Mobility

Venous ulcers: A reappraisal analyzing the effects of neuropathy, muscle involvement, and range of motion upon gait and calf muscle function

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

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