Venous disease is associated with an impaired range of ankle movement*

Dix, Francis; Brooke, Rebecca; McCollum, Charles

doi:10.1053/ejvs.2002.1885

Cited by 91 publications

(88 citation statements)

References 18 publications

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“…Some did not attend for their operation and others underwent surgery under local anaesthetic without stripping of the long saphenous vein. Factors other than venous reflux, such as coexisting medical problems or ankle stiffness causing poor calf muscle function, 34 may have contributed to recurrent ulceration in individual cases. Whether these patients experienced more ulcer free time after surgery as a result of less frequent or shorter episodes of recurrent ulceration remains unproved.…”

Section: Discussionmentioning

confidence: 99%

Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial

2007

BMJ

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Objective To determine whether recurrence of leg ulcers may be prevented by surgical correction of superficial venous reflux in addition to compression.Design Randomised controlled trial.Setting Specialist nurse led leg ulcer clinics in three UK vascular centres.Participants 500 patients (500 legs) with open or recently healed leg ulcers and superficial venous reflux.Interventions Compression alone or compression plus saphenous surgery.Main outcome measures Primary outcomes were ulcer healing and ulcer recurrence. The secondary outcome was ulcer free time.Results Ulcer healing rates at three years were 89% for the compression group and 93% for the compression plus surgery group (P=0.73, log rank test). Rates of ulcer recurrence at four years were 56% for the compression group and 31% for the compression plus surgery group (P<0.01). For patients with isolated superficial reflux, recurrence rates at four years were 51% for the compression group and 27% for the compress plus surgery group (P<0.01). For patients who had superficial with segmental deep reflux, recurrence rates at three years were 52% for the compression group and 24% for the compression plus surgery group (P=0.04). For patients with superficial and total deep reflux, recurrence rates at three years were 46% for the compression group and 32% for the compression plus surgery group (P=0.33). Patients in the compression plus surgery group experienced a greater proportion of ulcer free time after three years compared with patients in the compression group (78% v 71%; P=0.007, Mann-Whitney U test).Conclusion Surgical correction of superficial venous reflux in addition to compression bandaging does not improve ulcer healing but reduces the recurrence of ulcers at four years and results in a greater proportion of ulcer free time.Trial registration Current Controlled Trials ISRCTN07549334.

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Section: Discussionmentioning

confidence: 99%

Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial

2007

BMJ

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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%

“…Patients with CVD present limited ankle range of motion [36,45,47,78,98]. Diminished ankle mobility tends to aggravate as CVD progresses and in parallel with increasing severity of symptoms, thus further contributing to a poor CMPF [78,98].…”

Section: Impairment Of Calf Muscle Pump and Functional Capacitymentioning

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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“…135 Thus, heel-toe walking produces optimal calf muscle pump function. 135 Moreover, ankle range of motion has been significantly correlated with severity of venous insufficiency 136,137 and this may be related to the observed impaired calf muscle function in patients with venous disease. 138 Importantly, a single-arm pilot study and two small randomized control trials indicated that exercises that increase calf muscle strength and mobility also improve calf muscle function.…”

Section: Translations/interventionsmentioning

confidence: 99%

Provisional Matrix Deposition in Hemostasis and Venous Insufficiency: Tissue Preconditioning for Nonhealing Venous Ulcers

Parker

Broadbent

McGovern

et al. 2015

Advances in Wound Care

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Venous disease is associated with an impaired range of ankle movement*

Abstract: limbs with venous hypertension have a reduced range of ankle movement related to the clinical severity of venous disease.

Cited by 91 publications

References 18 publications

Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial

Long term results of compression therapy alone versus compression plus surgery in chronic venous ulceration (ESCHAR): randomised controlled trial

Manual Lymphatic Drainage in the Treatment of Chronic Venous Disease

Provisional Matrix Deposition in Hemostasis and Venous Insufficiency: Tissue Preconditioning for Nonhealing Venous Ulcers

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