The significance of calf muscle pump function in venous ulceration

Araki, Clifford T.; Back, Thomas L.; Padberg, Frank T.; Thompson, Peter; Jamil, Zafar; Lee, Bing C.; Durán, Walter N.; Hobson, Robert W.

doi:10.1016/0741-5214(94)90223-2

Cited by 203 publications

(145 citation statements)

References 12 publications

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“…Muscle pump dysfunction appears to be a major mechanism for the development of superficial venous incompetence and its complications such as venous ulcers. 24,25 Changes in the hemodynamics of the large veins of the lower extremity are transmitted into the microcirculation and eventually result in the development of venous microangiopathy. 18 Features of this microangiopathy include elongation, dilation, and tortuosity of capillary beds, thickening of basement membranes with increased collagen and elastic fibers, endothelial damage with widening of interendothelial spaces, and increased pericapillary edema with "halo" formation.…”

Section: Venous Pathophysiology and Dysfunctionmentioning

confidence: 99%

Chronic Venous Insufficiency

2005

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C hronic venous disease is often overlooked by primary and cardiovascular care providers because of an underappreciation of the magnitude and impact of the problem. The importance of chronic venous disease is related to the number of people with the disease and the socioeconomic impact of its more severe manifestations. Unfortunately, the literature concerning the prevalence and incidence of chronic venous disease has varied greatly because of differences in the methods of evaluation, criteria for definition, and the geographic regions analyzed. The most common manifestations of chronic venous disease are dilated cutaneous veins, such as telangiectases and reticular veins, and varicose veins. The term chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities with venous hypertension causing various pathologies including pain, swelling, edema, skin changes, and ulcerations. Although the term CVI is often used to exclude uncomplicated varicose veins, varicose veins have incompetent valves with increased venous pressure leading to progressive dilation and tortuosity. We will use the term CVI to represent the full spectrum of manifestations of chronic venous disease.Varicose veins have an estimated prevalence between 5% to 30% in the adult population, with a female to male predominance of 3 to 1, although a more recent study supports a higher male prevalence. 1 The Edinburgh Vein Study screened 1566 subjects with duplex ultrasound for reflux finding CVI in 9.4% of men and 6.6% of women, after age adjustment, which rose significantly with age (21.2% in men Ͼ50 years old, and 12.0% in women Ͼ50 years old). 2 The San Valentino Vascular Screening Project found among the 30 000 subjects evaluated by clinical assessment and duplex ultrasound a prevalence of 7% for varicose veins and 0.86% for "symptomatic" CVI. 3 As in previous studies, CVI was more common with increasing age, but there was no significant sex difference. The rate of varicose vein development may be estimated from the Framingham Heart Study, which found an annual incidence of 2.6% in women and 1.9% in men. 4 Risk factors found to be associated with CVI include age, sex, a family history of varicose veins, obesity, pregnancy, phlebitis, and previous leg injury. 5,6 There also may be environmental or behavioral factors associated with CVI such as prolonged standing and perhaps a sitting posture at work. 6,7 Varicose veins have a significant impact on healthcare resources, with millions of people seeking medical attention for their cosmetic appearance annually. Although often minimized, the cosmetic consequences may adversely affect an individual's quality of life and are associated with other manifestations.The more serious consequences of CVI such as venous ulcers have an estimated prevalence of Ϸ0.3%, although active or healed ulcers are seen in Ϸ1% of the adult population. 8 It has been estimated that Ϸ2.5 million people have CVI in the United States, and of those, Ϸ20% develop venous ulcers. 9 The ov...

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Section: Venous Pathophysiology and Dysfunctionmentioning

confidence: 99%

Chronic Venous Insufficiency

2005

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“…Effective venous return requires the interaction of a central pump, a pressure gradient, a peripheral venous pump, and competent venous valves to overcome the forces of gravity (Araki, Back et al, 1994;Ludbrook, 1966;Meissner, Moneta et al, 2007). Depending on activity and posture, 60 to 80% of the resting blood volume resides in the venous system (Katz, Comerota et al, 1994) and in the upright but motionless individual the hydrostatic pressure is higher (Meissner, Moneta, et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Influence of wearing an unstable shoe on thigh and leg muscle activity and venous response in upright standing

et al. 2012

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Purpose: To quantify the effect of unstable shoe wearing on muscle activity and haemodynamic response during standing.Methods: Thirty volunteers were divided into 2 groups: the experimental group wore an unstable shoe for 8 weeks, while the control group used a conventional shoe for the same period. Muscle activity of the medial gastrocnemius, tibialis anterior, rectus femoris and biceps femoris and venous circulation were assessed in quiet standing with the unstable shoe and barefoot.Results: In the first measurement there was an increase in medial gastrocnemius activity in all volunteers while wearing the unstable shoe. On the other hand, after wearing the unstable shoe for eight weeks these differences were not verified. Venous return increased in subjects wearing the unstable shoe before and after training. Conclusions:The unstable shoe produced changes in electromyographic characteristics which were advantageous for venous circulation even after training accommodation by the neuromuscular system.

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“…In its more severe forms, such as venous stasis ulcer, the ultimate expression of this disease, it can lead to disability and be a cause of high costs to public coffers. 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 .…”

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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The significance of calf muscle pump function in venous ulceration

Abstract: Venous insufficiency is necessary but not sufficient to cause ulceration, and a deficiency of the calf muscle pump is significant to the severity of venous ulceration.

Cited by 203 publications

References 12 publications

Chronic Venous Insufficiency

Chronic Venous Insufficiency

Influence of wearing an unstable shoe on thigh and leg muscle activity and venous response in upright standing

Avaliação das limitações de úlcera venosa em membros inferiores

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