The comparative hemodynamic efficacy of lower limb muscles using transcutaneous electrical stimulation

Evans, David; Williams, Katherine J.; Strutton, Paul H.; Davies, Alun H.

doi:10.1016/j.jvsv.2015.10.009

Cited by 9 publications

(8 citation statements)

References 32 publications

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“…The increase in microcirculatory flow indicated by increase in laser Doppler fluxmetre is to be expected with the increase in venous flow seen in groups B and C, and is in agreement with previous studies 24,48,49 as is the large confidence intervals due to the inevitable structural heterogeneity of the microvasculature. 50…”

Section: Discussionsupporting

confidence: 92%

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

et al. 2020

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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.

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Section: Discussionsupporting

confidence: 92%

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

et al. 2020

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“…This generates either an action potential in the nerve causing contraction of the calf muscle or the stimulus can directly excite muscle units without nerve activation [ 17 ]. This is an effective method in the treatment of VLUs since activation of the calf muscle pump is the most effective way of ejecting pooled blood from the lower leg [ 18 , 19 , 20 , 21 ]. This activation by an NMES device leads to an ejection volume from the venous compartment that is only slightly less than a voluntary contraction [ 22 ].…”

Section: Introductionmentioning

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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“…[ 21 , 22 ] This can be explained by 2 factors: bed rest causes a decline in venous blood flow, so a higher increase compared to resting values can be expected; in addition, in these researches only the NMES “on time” was compared to baseline, not considering off time where a subsequent cessation in blood flow might happen. Few studies have considered percentage of change, and lower range values have been reported stimulating common peroneal nerve [ 9 , 23 ] or different muscle locations [ 17 ] in healthy volunteers. In these studies a long-lasting hemodynamic recording of 15 seconds was used, as has been also recorded in the present study, to deal with cardiac and respiratory variations.…”

Section: Discussionmentioning

confidence: 99%

“…[ 19 ] In another study testing different muscles (soleus was not included), gastrocnemius medial was the only muscle where, besides an increased PV from baseline, a higher FV was detected. [ 17 ] Explanations from the authors in both researches are in connection with the intimate relationship among the muscles and plexus of deep veins. The leg pump—located in the veins of the soleus muscle—and the popliteal pump—located in the gastrocnemius muscle—are considered together as the calf muscle pump, which is the most important pump in the lower limb.…”

Section: Discussionmentioning

confidence: 99%

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Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow

Martínez-Rodríguez¹,

Senin-Camargo²,

Raposo-Vidal³

et al. 2018

Medicine

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Background:Transcutaneous electrical nerve stimulation (TENS) is used to prevent venous stasis and thromboembolism. However, best electrostimulation parameters have yet to be established. The aim of the study was to compare the hemodynamic effects and the participants’ relative discomfort of 3 TENS sequences at the maximum tolerated intensity stimulus.Methods:Twenty-four healthy university students (50% male) participated in a cross-over, randomized study. Each participant received 2 TENS sequences on peroneal nerve at 1 and 5 Hz, and the third one on soleus muscle at 5 Hz. Popliteal flow volume (FV) and peak velocity (PV) were measured using Doppler ultrasound and the relative change from basal values was recorded. Discomfort questionnaires -visual analogue scale (VAS) and verbal rating scale (VRS)- were also administered to compare sensations among the three applications.Results:All interventions produced significant hemodynamic responses compared to baseline. Both 5 Hz applications obtained higher FV increments than 1 Hz TENS (P < .001). The muscle application resulted in the lowest PV increment (P < .001). TENS at 5 Hz on nerve location was the worst tolerated, with higher values in VRS (P = .056) and VAS (P = .11), although not significant.Conclusion:TENS at 5 Hz on soleus site may be the most appropriate protocol for enhancing venous return.

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The comparative hemodynamic efficacy of lower limb muscles using transcutaneous electrical stimulation

Cited by 9 publications

References 32 publications

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

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

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

Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow

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