Use of duplex sonography to investigate the effect of active and passive movement at the ankle joint for promoting venous return

Abstract

Among the joint and muscle pumps that are hemodynamically active and, in particular, bring about venous return in the lower limb, the so-called ankle pump is of paramount importance. The basic anatomical relationship of the talocrural joint to the venous network around the ankle is reviewed. Duplex sonographic measurement of the rate of blood flow in the great saphenous vein at the saphenous opening, at rest and during active and passive movements at the ankle joint, shows that such movements have an important effect on the rate of flow through the adjacent veins. Passive movement of the foot relative to the leg was brought about by a newly developed apparatus that can be either pneumatically or electrically operated. The action of the ankle pump against venous stasis, the arthrogenic congestive syndrome, and chronic venous insufficiency has demonstrated the prophylactic importance of this physiological mechanism. It can, when necessary, be replaced by an appropriately designed apparatus.

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

“…35 The venous blood flow velocity registered during the active movement of the ankle increased by 20-40%, 35 which is similar to the increase in blood flow velocity found during the call-up and reabsorption maneuvers in this study. 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.…”

Cardiovascular responses at the onset of passive leg cycle exercise in paraplegics with spinal cord injury

“…Unfortunately, no studies have reported the circulation time from the lower limbs to the heart. However, circulation time is clearly at least several seconds, according to studies of the venous blood velocity in the lower limbs during passive movement of the foot that have been reported by Staubesand et al (1995) and the circulation time from the lower limbs to other regions by Katori (1997). Thus, the delayed increase in SV supported the promotion of venous return from the paralyzed lower limbs during PLCE in PSCI.…”

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

“…Previous reports, which examined flow velocity at the popliteal vein employing duplex ultrasonography, also found progressive decrease in blood flow acceleration with repetitions of calf dynamic contractions. 27 Furthermore, in this study the healthy participants were slightly younger and with lower BMI compared with the CVD participants. Younger age and less weight are usually associated with stronger muscles, 28,29 which also may contribute to improve the venous flow velocity during contractions.…”