Abstract
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.
Highlights
There is an increasing global incidence of people presenting with venous leg ulcers (VLUs) [1]
We explored the capability of two portable neuromuscular electrical stimulation (NMES) devices to improve the hemodynamic performance of the lower limb in young healthy adults
The peak venous velocity (PV) for voluntary contractions was significantly greater than that produced by the GekoTM devise (P < 0.0001), which in turn was significantly greater than that recorded with the National University of Ireland (NUI) Galway device (P = 0.0175) (Table 1, Figure 2)
Summary
There is an increasing global incidence of people presenting with venous leg ulcers (VLUs) [1]. CVI develops due to a number of related conditions that affect the hemodynamics in the lower leg, but there is no distinct pattern in which they occur [2] One of these factors includes an increased hydrostatic pressure as a result of venous reflux in the superficial veins, due to valve dysfunction. There can be damage resulting from thrombosis, weakness in the vascular walls, or deformities, which affect deep veins, leading to valve incompetence Another factor that can contributes is chronic muscle or joint inflammation resulting in a reduced range of motion, leading to underactivation of the calf muscle pump, and resulting in poor venous outflow, leading to prolonged venous stasis [3,4]. Recent figures predict that 1% of the population in the Western world suffer from VLUs, with the full economic cost of VLUs estimated at $15 billion annually to the health budget of the USA alone [5,6]
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