Abstract
Objectives: to investigate the relationship between clinical severity of venous disease, calf muscle pump dysfunction and range of ankle movement (ROAM). Materials and Methods: ROAM was assessed by goniometry in the supine, nonweightbearing position. Calf muscle pump function was assessed by ambulatory venous pressure (AVP), calculating the pressure relief index (PRI). Venous disease was classified according to the CEAP classification (International Consensus Committee reporting standards on venous disease). Forty seven limbs in 38 adults were recruited and matched for age: 11 normal controls CEAP0, 12 varicose veins CEAP2, 12 chronic venous insufficiency CEAP4,5 and 12 active ulceration CEAP6. Results: mean ( s.e.m.) age was 60.7 (1.3) years. Mean (s.e.m.) PRI was 1959.6 (313.7) in CEAP0, 905.3 (139.3) in CEAP2, 596.5 (148.5) in CEAP4,5 and 170.6 (69.0) in CEAP6 (p < 0.001, ANOVA). Mean (s.e.m) ROAM was 61.3 (2.0)° in CEAP0, but significantly reduced to 49.7 (2.0) in CEAP2, 42.1 (2.6) in CEAP4,5 and 40.9 (2.7) in CEAP6 (p < 0.004, ANOVA post hoc Tukey). PRI correlated with ROAM (p < 0.001, Pearson correlation coefficient r = + 0.52). Conclusions: limbs with venous hypertension have a reduced range of ankle movement related to the clinical severity of venous disease.Eur J Vasc Endovasc Surg 25, 556-561 (2003)
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