Adjustable Velcro Research Articles

Adjustable Velcro® compression devices as compared to 4-layer compression bandages for the treatment of venous leg ulcers and optimisation of patient satisfaction

Adjustable Velcro® compression devices as compared to 4-layer compression bandages for the treatment of venous leg ulcers and optimisation of patient satisfaction

Development of elbow rehabilitation device with iterative learning control and internet of things

In this study, we present a novel approach for rehabilitation devices through the design of an active elbow joint orthosis, inspired by the fundamental principles of robotic exoskeletons. The device not only enables home-based usage but also facilitates the transmission of exercise data from patients to physiotherapists via the Internet of Things (IoT) device. This approach offers the possibility of increased therapy sessions for each patient while allowing physiotherapists access to data for real-time or subsequent analyses, thereby establishing a database. This permits a single physiotherapist to manage multiple patients more effectively. The developed mobile application within this research incorporates a distinct entry interface for both patients and physiotherapists. Maximum force and position values generated during each exercise period are displayed within the application. The device enables active exercise with a single degree of freedom at the elbow joint and is equipped with force sensors to ensure safety against potential high-shear forces. Furthermore, it can be worn on the upper extremity using adjustable Velcro straps to accommodate users with varying arm circumferences. Specifically, this system amalgamates two primary components: a microcontroller operating control algorithms and IoT technology, and a smartphone application containing interfaces for physiotherapists and users undergoing therapy. The control design of the device employs a P-Type Iterative Learning Control (ILC) due to periodic exercise movements, reducing the error norm by approximately 20% during each exercise period (excluding the initial period). The controller consistently diminishes error values with each iteration, ultimately converging to zero. Throughout an exercise lasting around 3 minutes, the average error norm is recorded as 0.229⁰. In essence, this study presents a pioneering approach that sets itself apart from other research by minimizing shear forces and errors through a specialized controller, all while enabling remote, home-based rehabilitation under expert supervision.

A dual realist review: Compression for leg swelling at the end of life has potential quality of life benefit.

To examine the evidence for the use of compression in the general population and determine how far it can be used to inform treatment at the end of life. In advanced illness, some patients suffer lower limb swelling and its resulting problems. In the general population, compression is used to treat lower limb swelling, but little is known about its use at the end of life. This review is designed to deeply explore the available evidence and identify what is known and areas for further research. Five databases were searched; CINAHL, MEDLINE, Embase, AMED and Cochrane, in November 2021. Reference lists for included studies were hand-searched. A web search was carried out. Two parallel realist reviews were performed. The first reviewed the use of compression in the general population. The second explored lower limb swelling at the end of life. Findings were screened using inclusion and exclusion criteria, quality assessed and qualitative and quantitative data extracted. The initial searches returned 1179 articles in review one and 839 articles in review two. Following the screening, 10 articles remained in each review for analysis. A programme theory was drawn for each review. The theories had sufficient similarities to allow evidence from the general population to be used to make recommendations for those at the end of life. People with advanced illness and leg swelling suffer physically and psychologically. Compression delivers a reduction in swelling and quality of life benefit in the general population. This study found people with advanced illness may experience the same benefits. A cautious approach should be taken and stockings or adjustable Velcro compression devices (AVCDs) are likely to be the best starter interventions. Existing guidelines should also be consulted. Further research to develop the right intervention in this group is needed.

How Can Adjustable Velcro Wraps Help in the Management of Lymphedema in the Absence of Complex Physical Therapy Facilities.

Background: Lymphedema is a progressive disorder characterized by impairment of lymph flow from tissues to the blood circulation due to damage of lymphatics. Treatment can be surgical or nonsurgical. A great number of operative procedures described in the literature demonstrate no single method exists that could be regarded as a standard. Nonsurgical therapy consists of a set of four physiotherapeutic measures, if properly performed; it treats the cause of lymphedema in a manner free of side effects, this set is called complex physical therapy (CPT). Criteria and facilities of CPT are not available in Iraq now. Methods and Results: Below is a short clinical experience of seven cases (nine diseased lower limbs) presented at our clinic for management of lymphedema who were all managed successfully during the decongestive period using adjustable Velcro wraps (AVW). Conclusions: In the absence of ideal CPT facilities, AVW can be used as a single therapeutic modality for treatment of lymphedema.

A proximal interphalangeal joint custom-made orthosis in trigger finger: Functional outcome.

Trigger finger is a common and functionally limiting disorder. Finger immobilization using an orthotic device is one of the conservative treatment options for treating this condition. The most common orthosis previously described for trigger finger is metacarpophalangeal joint immobilization. There are limited studies describing the effectiveness of proximal interphalangeal joint orthosis for treatment of trigger finger. This study was a single group pretest-posttest design. Adult patients with single digit idiopathic trigger finger were recruited and asked to wear a full-time orthoses for 6 weeks. The pre- and post-outcome measures included Quick-DASH score, the Stages of Stenosing Tenosynovitis (SST), the Visual Analogue Scale (VAS) for pain, the number of triggering events in ten active fists, and participant satisfaction with symptom improvement. Orthotic devices were made with thermoplastic material fabricated with adjustable Velcro tape at the dorsal side. All participants were given written handouts on this disease, orthotic care and gliding exercises. Paired t-tests were used to determine changes in outcome measures before and after wearing the orthosis. There were 30 participants included in this study. Evaluation after the use of PIP joint orthosis at 6 weeks revealed that there were statistically significant improvements in Quick-DASH score from enrolment (mean difference -29.0 (95%CI -34.5 to -23.4); p < 0.001), SST (mean difference -1.4 (95%CI -1.8 to -1.0); p < 0.001) and VAS (mean difference -3.4 (95%CI -4.3 to -2.5); p < 0.001). There were no serious adverse events and patient satisfaction with the treatment was high. Despite our small study size, the use of proximal interphalangeal joint orthosis for 6 weeks resulted in statistically significant improvements in function, pain and triggering, and also high rates of acceptance in patients with isolated idiopathic trigger finger.

Review of adjustable velcro wrap devices for venous ulceration

Compression therapy is the mainstay of treatment for patients with venous leg ulcers. Current gold standard is 4 layer bandaging, which has a significant impact on patients comfort, ability to wear their own shoes, and quality of life, as well as taking significant time to apply, and losing compression over time. This systematic review aims to evaluate the use of Velcro wrap devices for the treatment of venous ulceration. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used to identify articles reporting the use of Velcro wrap devices in patients with venous ulceration. Sixteen articles were identified (14 case series, 1 randomised trial, and 1 audit) reporting on 192 patients. There were reports of improved time to healing, reduced cost by >50%, reduced number and duration of nursing appointments, and improved quality of life in patients in Velcro wrap devices. Although the evidence remains poor, Velcro devices have potential to improve outcomes for patients with venous ulceration and further good quality studies should be undertaken to evaluate these further.

Compression therapy and exercise: enhancing outcomes

Compression therapy is the main method used in treating lymphoedema and chronic oedema. When combined with exercise, the authors found that patients in their practice had improved outcomes; making it vital for health professionals to keep up-to-date with this practice Compression therapy is the main method used in the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap-based systems led to a decrease in limb volume in one case study. The results of the programme indicate that the approach is beneficial and requires embedding further in Walsall lymphoedema service, due to improved patient outcomes, and cost effectiveness in terms of resources.

Compression systems used in lymphoedema management.

British Journal of NursingVol. 27, No. 20 FocusCompression systems used in lymphoedema managementTracy GreenTracy GreenSearch for more papers by this authorTracy GreenPublished Online:12 Nov 2018https://doi.org/10.12968/bjon.2018.27.20.1150AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Hobday A. Use of compression therapy in patients with lymphoedema. Nurs Stand. 2016; 30(27):50–58. https://doi.org/10.7748/ns.30.27.50.s46 Crossref, Medline, Google ScholarInternational Lymphoedema Framework. Best practice for the management of lymphoedema. 2006. https://tinyurl.com/y8hhd66c (accessed 22 October 2018) Google ScholarMoffatt CJ, Keeley V, Franks PJ, Rich A, Pinnington LL. Chronic oedema: a prevalent health care problem for UK health services. Int Wound J. 2017; 14(5):772–781. https://doi.org/10.1111/iwj.12694 Crossref, Medline, Google ScholarMosti G, Cavezzi A, Partsch H, Urso S, Campana F. Adjustable Velcro compression devices are more effective than inelastic bandages in reducing venous edema in the initial treatment phase: a randomized controlled trial. Eur J Vasc Endovasc Surg. 2015; 50(3):368–374. https://doi.org/10.1016/j.ejvs.2015.05.014 Crossref, Medline, Google ScholarPartsch H, Moffatt C. An overview of the science behind compression bandaging for lymphoedema and chronic oedema. In International Lymphoedema Framework. Compression therapy: a position document on compression bandaging. Best practice for the management of lymphoedema. 2nd edn. 2012. https://tinyurl.com/ycxxbufj (accessed 22 October 2018) Google Scholar FiguresReferencesRelatedDetailsCited byCase study: night compression use in a patient with Milroy's diseaseAmbreen Chohan, Simon Sumner, Mairi Olivier, Justine Whitaker23 June 2022 | British Journal of Nursing, Vol. 31, No. 12Examination of the effects of a new compression garment on skin tissue oxygenation in healthy volunteersAmbreen Chohan, Lauren Haworth, Simon Sumner, Mairi Olivier, Daniel Birdsall, Justine Whitaker11 July 2019 | Journal of Wound Care, Vol. 28, No. 7Leg care: improving assessment and adherenceDrew Payne13 June 2019 | Nursing and Residential Care, Vol. 21, No. 7 8 November 2018Volume 27Issue 20ISSN (print): 0966-0461ISSN (online): 2052-2819 Metrics History Published online 12 November 2018 Published in print 8 November 2018 Information© MA Healthcare LimitedPDF download

Compression therapy and exercise: enhancing outcomes.

Compression therapy is the main method used within the treatment and management of lymphoedema and chronic oedema. The increasing prevalence of the condition, which has multiple causes, such as genetic factors, age and external factors, require the effective management of the condition, and to enhance the management methods used to contain the condition. The use of exercise alongside the mainstay method of treatment (compression therapy) has been an underutilised area. The application of a structured exercise programme in conjunction with multi-layer lymphoedema bandaging combined with an adjustable velcro wrap based systems led to a decrease in limb volume in one case study. The results of the programme indicate that the approach is beneficial and requires embedding further within Walsall lymphoedema service, due to improved patient outcomes, and cost effectiveness in terms of resources.

Evaluation of three different devices to reduce stasis edema in poorly mobile nursing home patients.

Prolonged immobility in the sitting position in the elderly is known to produce venous stasis with leg edema and possible skin changes. Compression stockings are often applied for this clinical problem. There is few experienced nursing staff available to supervise the difficult task of stocking application. The authors have researched other effective and simple devices that may be suitable alternatives. This article reports the results of three different devices to reduce leg edema, as measured by reduction in leg volume: an electro-stimulation device, an adjustable compression Velcro® wrap and a short stretch bandage, each tested over a two-hour period. In this randomized pilot study including 38 patients, the authors observed no difference in leg volume following electro-stimulation (Veinoplus®). They noted a significant reduction in leg volume following use of the other two devices, more with the adjustable Velcro® wrap compression (Circaid Juxtafit®) than with the short stretch bandage (Rosidal K®). Measurement of the interface pressures created by these two devices and also assessing the stiffness created by applying each device for two hours confirm that pressure is more important than stiffness in the reduction of edema in these particular patients. This pilot study is to be added to the results of previous published studies showing the efficacy in reducing leg edema of Velcro® adjustable compression wrap and its ease of use.

A System for Simultaneous Finger Joints Goniometric Measurements Based on Inertial Sensors

In this work, a system to record continuously and simultaneously the flexion and extension of finger joints and to compute a range of motion of the hand joints is presented. The system is based on micro-inertial sensors and a graphical interface in LabVIEW with a mathematical algorithm for signal conditioning. Ten sensors were attached to fingers with adjustable velcro belts, eight on proximal and distal phalanges from index to little fingers, one on the proximal phalanx of the thumb and another on the hand dorsum. The evaluation protocol consisted of 3 sessions of 10 repetitions each, on both hands of 6 healthy volunteers where the angular trajectory was recorded during grasping a 7.8 cm diameter sphere. A statistical analysis was performed in order to determine the variation among the measurements. The purpose of this study was to demonstrate the suitability of this system for simultaneous measurements of range of motion during flexion and extension, considering that it can be used interchangeably in the two hands, regardless the size. The results showed that the developed system is suitable for registering objectively the range of motion of the hand.

Multinational, pilot audit of a Velcro adjustable compression wrap system for venous and lymphatic conditions.

The aim of this small pilot audit was to record the performance of an adjustable Velcro compression wrap, ReadyWrap, and the experiences of patients and health-care professionals using the system as a self-care option for the management of venous and lymphatic leg conditions in both the treatment and maintenance phases. This audit was held within a 4-week review period. Participants included venous leg ulcer (VLU) patients with and without oedema, and patients with lymphoedema. Where open wounds were present they were managed with debridement, skin care and dressings according to clinical need. Lymphoedema patients received manual lymphatic drainage and skin care regimens as per standard practice. The Velcro system evaluated formed part of a treatment pathway with compression bandages and/or compression hosiery as clinically indicated. Patients, carers and health-care professionals applied the garments following assessment and training. Objective data recorded included change in circumferential measurements and improvement in wound status. Observation of health-care professionals, patients and carers with regard to the comfort and ease of application/removal of the device were recorded. There were 17 patients included in the audit. Within the 4-week period a reduction in limb circumference was recorded in all cases. Improvements in open wounds were recorded in most cases. Following the 4-week audit period 94% of the application of the device was performed by either the patient (59%) or the carer (35%) thereby reducing the health-care professional contact that was required for application. Early results in this small audit demonstrate that this adjustable Velcro compression wrap may provide a simple, clinically effective and patient-acceptable solution for self-care with compression. Use of this type of device could have the potential to reduce overall health-care burden by reducing necessary skilled treatment visits and/or cost while still achieving good clinical outcomes. Further studies are required to confirm this pilot study and provide additional data.

Adjustable Velcro® Compression Devices are More Effective than Inelastic Bandages in Reducing Venous Edema in the Initial Treatment Phase: A Randomized Controlled Trial

The objective of this study was to compare the efficacy and comfort of inelastic bandages (IBs) and adjustable Velcro® compression devices (AVCDs) in reducing venous leg edema in the initial treatment phase. Forty legs from 36 patients with untreated venous edema (C3EpsAsdPr) were randomized to two groups. Patients in the first group received IBs (n = 20) and those in the second AVCDs (n = 20). Both compression devices were left on the leg day and night, and were renewed after 1 day. Patients in the AVCD group were asked to re-adjust the device as needed when it felt loose. Leg volume was calculated using the truncated cone formula at baseline (T0), after 1 day (T1) and after 7 days (T7). The interface pressure of the two compression devices was measured by an air filled probe, and the static stiffness index calculated after applying compression at T0 and T1, and just before removal of compression on T1 and T7. Patient comfort with regard to the two compression systems was assessed by grading signs and symptoms using a visual analog scale. At T1, the median percent volume reduction was 13% for the IB group vs 19% for the AVCD group; at T7 it was 19% vs 26%, respectively (P < .001). The pressure of the IBs was significantly higher compared with the AVCDs at T0 (63 vs 43 mmHg) but dropped by >50% over time, while it remained unchanged with AVCDs owing to the periodic readjustment by the patient. Comfort was reported to be similar with the two compression devices. Re-adjustable AVCDs with a resting pressure of around 40 mmHg are more effective in reducing chronic venous edema than IBs with a resting pressure of around 60 mmHg. AVCDs are effective and well tolerated, not only during maintenance therapy, but also in the initial decongestive treatment phase of patients with venous leg edema.

Commentary on ‘Adjustable Velcro Compression Devices are More Effective than Inelastic Bandages in Reducing Venous Edema in the Initial Treatment Phase: A Randomized Controlled Trial’

Mosti et al. have compared the use of inelastic bandages (IBs) with an adjustable Velcro compression device (AVCD) (Circaid Juxtafit; Medi GmbH, Bayreuth, Germany) applied to the legs of patients with edema. This is a very important study demonstrating the effectiveness of an AVCD in the management of leg edema. The ability of the patient to adjust the AVCD as leg swelling abates is critical to the success of the Velcro method. It is not feasible to rewrap inelastic bandages daily, and the importance of having the patient participate in their treatment is key to long-term success. Owing to the excellent static stiffness achieved with the Velcro wraps, the inelastic properties of the AVCD are ideal in reducing swelling. The static stiffness index may be defined as the difference in sub-bandage or wrap pressure from the lying to the standing position. A rise of 10 mmHg or more is considered a good value to increase the flow of blood out of the leg. Stockings, however, show little or no increase in pressure when comparing the lying with the standing position, and these properties help explain why many patients with significant leg swelling are not helped by the stockings. Another group of patients with swelling are candidates for the AVCD as they have serious donning and/or doffing difficulties. This is especially true in the elderly population, where lack of strength in the hands and/ or arthritic changes impede the ability to use stockings. Another important use of AVCDs is after knee replacement or other orthopedic procedures where swelling may be commonly encountered. The ease of application and the ability to increase blood flow out of the leg limiting edema may also have benefit as an adjunctive method for thrombosis prophylaxis. This is especially true in those who have leg swelling preoperatively.

Adjustable Velcro® Compression Devices are More Effective than Inelastic Bandages in Reducing Venous Edema in the Initial Treatment Phase: A Randomized Controlled Trial

The objective of this study was to compare the efficacy and comfort of inelastic bandages (IBs) and adjustable Velcro compression devices (AVCDs) in reducing venous leg edema in the initial treatment phase. Forty legs from 36 patients with untreated venous edema (C3EpsAsdPr) were randomized to two groups. Patients in the first group received IBs (n = 20) and those in the second AVCDs (n = 20). Both compression devices were left on the leg day and night, and were renewed after 1 day. Patients in the AVCD group were asked to re-adjust the device as needed when it felt loose. Leg volume was calculated using the truncated cone formula at baseline (T0), after 1 day (T1) and after 7 days (T7). The interface pressure of the two compression devices was measured by an air filled probe, and the static stiffness index calculated after applying compression at T0 and T1, and just before removal of compression on T1 and T7. Patient comfort with regard to the two compression systems was assessed by grading signs and symptoms using a visual analog scale. At T1, the median percent volume reduction was 13% for the IB group versus 19% for the AVCD group; at T7 it was 19% versus 26%, respectively (p < .001). The pressure of the IBs was significantly higher compared with the AVCDs at T0 (63 vs. 43 mmHg) but dropped by > 50% over time, while it remained unchanged with AVCDs owing to the periodic readjustment by the patient. Comfort was reported to be similar with the two compression devices. Re-adjustable AVCDs with a resting pressure of around 40 mmHg are more effective in reducing chronic venous edema than IBs with a resting pressure of around 60 mmHg. AVCDs are effective and well tolerated, not only during maintenance therapy, but also in the initial decongestive treatment phase of patients with venous leg edema.

Three-Dimensional Body Scan Data Analysis

Three-dimensional body scanning technology was used to analyze fit of women's pants and to measure garment ease at various locations. Special test pants constructed with adjustable Velcro sections were used to provide custom fit for each study participant. Twenty-four subjects, ages 35 to 55, represented three body shape groups (straight, medium, curvy) determined by the hip-to-waist circumferences ratio, and four size groups covering Misses size range 4 to 16. Scans of a subject wearing minimal clothing and of the same subject wearing the test pant, adjusted by the researchers for best fit in a standing position, were compared. The differences between the pant and body scans (ease) were determined for circumference, slice area, surface area, and volume measurements at various locations and analyzed for size and shape dependence. Decrease in percent ease differences with increasing size was observed for several variables; no clear dependence on shape was found. Size dependences were used to propose a way of pattern grading with grade intervals variable by size and body location.