The use of ultrasound in the evaluation of the efficacy of calf muscle pump function in primary chronic venous disease

Crisóstomo, Rute; Candeias, M.S.; Armada-da-Siva, P A S

doi:10.1177/0268355512471757

Cited by 17 publications

(14 citation statements)

References 32 publications

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“…The increase in blood flow velocity in the superficial GSV during active and passive movements of ankle is also similar to that observed here using call-up and reabsorption maneuvers. 36 In the standing position and during active tip-toe movements, blood flow velocity in the popliteal vein also increases in response to calf muscle pump contractions, 28 but in this case and contrary to what was observed in the present study, healthy subjects demonstrated larger enhancement in venous blood flow as a result of the tip-toe movement. 28 There are few studies that describe and demonstrate the efficacy of MLD maneuvers on venous blood flow.…”

contrasting

confidence: 94%

Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study

Crisóstomo

Candeias²,

Ribeiro

et al. 2013

Phlebology

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contrasting

confidence: 94%

Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study

Crisóstomo

Candeias²,

Ribeiro

et al. 2013

Phlebology

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“…Such apparent calf pump dysfunction might be related to weak calf muscles in CVD patients [29,30] and is compatible with a lower ejection volume, such as has been measured before in this population with air-plethysmography [92]. In addition, abnormal venous blood reflux from deep to superficial venous system through incompetent perforator veins may blunt blood flow through the popliteal vein [104].…”

Section: Impairment Of Calf Muscle Pump and Functional Capacitymentioning

confidence: 54%

“…Popliteal peak flow volume is maximal during the first contraction of the tip-toe set of ten repetitions when the venous reservoir is full [103]. In the CVD patients, but not in the healthy subjects, venous flow augmentation was seen to diminish during the ten tip-toe exercise [104]. Such apparent calf pump dysfunction might be related to weak calf muscles in CVD patients [29,30] and is compatible with a lower ejection volume, such as has been measured before in this population with air-plethysmography [92].…”

Section: Impairment Of Calf Muscle Pump and Functional Capacitymentioning

confidence: 90%

“…Also, gastrocnemius thickness and some other muscle architectural features, like pennation angle, are similar in patients with low to moderate CVD severity and healthy participants, and seem unrelated with the severity of CVD [104]. Despite this fact, for the medial gastrocnemius, a few morphological parameters (like higher muscle fascicle length, and pennation angle) are associated with the degree of increase in peak flow velocity in the popliteal vein during tip-toe movement [104].…”

Section: Impairment Of Calf Muscle Pump and Functional Capacitymentioning

confidence: 94%

“…Despite no evidence that MLD prevent secondary complications associated to venous stasis, like venous thrombosis, the use of MLD may be an option to increase superficial and deep venous flow [23,104]. In particular, MLD is recommended before venous surgery and should be complemented with compression stockings [17,18].…”

Section: Recommendations For Treating Cvd With Mldmentioning

confidence: 99%

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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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A 1D pulse wave propagation model of the hemodynamics of calf muscle pump function

Keijsers

Leguy

Huberts

et al. 2015

Numer Methods Biomed Eng

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The calf muscle pump is a mechanism which increases venous return and thereby compensates for the fluid shift towards the lower body during standing. During a muscle contraction, the embedded deep veins collapse and venous return increases. In the subsequent relaxation phase, muscle perfusion increases due to increased perfusion pressure, as the proximal venous valves temporarily reduce the distal venous pressure (shielding). The superficial and deep veins are connected via perforators, which contain valves allowing flow in the superficial-to-deep direction. The aim of this study is to investigate and quantify the physiological mechanisms of the calf muscle pump, including the effect of venous valves, hydrostatic pressure, and the superficial venous system. Using a one-dimensional pulse wave propagation model, a muscle contraction is simulated by increasing the extravascular pressure in the deep venous segments. The hemodynamics are studied in three different configurations: a single artery–vein configuration with and without valves and a more detailed configuration including a superficial vein. Proximal venous valves increase effective venous return by 53% by preventing reflux. Furthermore, the proximal valves shielding function increases perfusion following contraction. Finally, the superficial system aids in maintaining the perfusion during the contraction phase and reduces the refilling time by 37%. © 2015 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons Ltd.

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The use of ultrasound in the evaluation of the efficacy of calf muscle pump function in primary chronic venous disease

Abstract: Patients with moderate CVD have lower FV during calf muscles contraction but similar muscle anatomical characteristics compared with healthy controls. Changes in calf muscles flexibility and fatigue resistance may be investigated as possible causes of calf pump dysfunction.

Cited by 17 publications

References 32 publications

Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study

Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

A 1D pulse wave propagation model of the hemodynamics of calf muscle pump function

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