Increase In Foot Volume Research Articles

Assessing the Influence of Unstable Footwear on Lower Limb Lymphedema

Introduction: Unstable shoes may benefit lower limb lymphedema patients by reducing foot volume and relieving symptoms. Objective: The objective of this study was to evaluate and compare the effectiveness of unstable shoes versus conventional sports shoes in managing lower limb lymphedema, focusing on changes in foot volume, circumference, and symptom relief. Methods: We conducted an 8-week clinical trial, recruiting patients with lower limb lymphedema. Participants were divided into 2 groups: one using unstable shoes and the other using conventional sports shoes. Measurements of foot volume and circumference were taken at the beginning and end of the trial. Additionally, participants were asked to report any changes in leg cramps and paraesthesia during the study period. Results: The results indicated a nonstatistically significant tendency toward a decrease in foot volume and circumference in the intervention group using unstable shoes. In contrast, the control group using conventional sports shoes showed a tendency toward an increase in foot volume and a statistically significant increase in foot circumference. Moreover, participants in the unstable shoes group reported a decrease in leg cramps and paraesthesia, indicating potential symptom relief. Conclusions: This study suggests that unstable shoes have the potential to offer benefits to individuals with lower limb lymphedema, particularly in terms of foot volume reduction and symptom relief. The use of unstable shoes may be suitable for activities such as walking and extended periods of standing. However, further research is necessary to explore their full potential and effectiveness in managing lymphedema symptoms comprehensively.

Investigating the inhibition of NMDA glutamate receptors in the basolateral nucleus of the amygdala on the pain and inflammation induced by formalin in male Wistar rats

The role of the amygdala in controlling emotional pain has been emphasized in several studies. In this study, the role of the NMDA glutamate receptors in the basolateral nucleus of the amygdala (BLA) in regulating inflammation and emotional pain, induced by formalin, was studied in male rats. Male Wistar rats, weighing 250±20 g, were injected with 20 μL of 2% formalin into the paw of the right hind limb. Memantine, at doses of 1 and 5 mg/rat, was injected bilaterally into the BLA five minutes prior to injecting formalin. Following the injection, the pain and inflammation of the paws were measured using Dubbison-Dennis and mercury immersion methods, respectively. The behavior of the animals, including licking time and foot volume, was assessed. The results showed that the inactivation of the NMDA receptors in the BLA in the acute phase of pain reduced the licking time (the emotional aspect of pain). However, at a high dose (5 μg/rat), memantine exacerbates the pain induced by formalin in the chronic phase. Additionally, the inhibition of the NMDA receptors in the BLA by memantine enhanced the formalin-induced increase in foot volume (inflammation) in a dose-dependent manner. The study showed that the NMDA glutamate receptors in the BLA are crucial for the emotional pain and inflammation in both chronic and acute phases of formalin-induced pain. However, their roles are more pronounced in the chronic phase than in the acute phase of pain.

The Effect of Graduated Compression Garments on Foot Volume During Running

Compression stockings are commonly recommended to help reduce edema in the lower extremities at rest; however, the effect of wearing compression stockings on lower extremity edema during exercise remains a mystery. Understanding the effects of compression stockings on foot volume during exercise could potentially increase the type of aerobic activities available to adults with conditions contributing to lower extremity edema. PURPOSE: To determine if compression stockings will reduce running associated increases in foot volume compared to running without compression stockings. METHODOLOGY: Ten recreational runners (8 male, 2 female; 27.3±5.8 yrs; 73.2±8.4 kg, VO2max 49.1±5.9 ml/kg/min) completed two 20 min submaximal treadmill runs (1% grade, 11.2±1.1 km/hr, 72.3±2.9% of VO2max) with a compression sock or sleeve on the dominant leg and a regular sock on the control leg. Compression and control foot volume was measured using a foot volumeter before and after each trial and compared using a repeated-measures ANOVA. Pre and post run volume comparisons within groups were performed using a paired t-test (α=0.05). RESULTS: In response to 20 min of treadmill running, foot volume significantly increased (p<0.05) in the control leg of the sock and sleeve trials (4.2±2.4 and 6.0±4.9%), as well as in the sleeve leg (3.1±3.5%). There was a non-significant trend for an increase in the sock leg (1.8±3.1%; p=0.08). The overall increase in foot volume was greater (p<0.05) in the control leg compared to the sock (24±14.1 to 11±17.8ml) and sleeve (33.0±27.5 to 17.5±20.8ml) legs, respectively. There was no difference in foot volume when comparing the effects of the compression sock to the sleeve. CONCLUSION: Use of a compression sock or sleeve appears to reduce the observed increase in foot volume experienced among runners, and this effect may be greater with a compression sock than sleeve.

The effects of loaded, unloaded, dynamic, and static activities on foot volumetrics

Objectives: The objective of this study was to compare loaded activities (standing and walking) versus unloaded activities (stationary biking and sitting), and dynamic activities (stationary biking and treadmill walking) versus static activities (sitting and standing) on foot volumetrics. Design: This study was a single-group, repeated measures design. Methods: Thirty-four subjects participated in four different sessions (sitting, standing, stationary biking, and walking) over 3 weeks. Each randomly assigned activity was performed for 12 min. Pre- and post- foot volumes were measured. Results: A 2 (within subject − pre and post)×4 (between subject – condition) ANOVA was significant for an interaction ( p=0.041). Post-hoc testing revealed significantly greater increases for the two loaded conditions, standing ( p<0.0005) and walking ( p=0.003), whereas no differences were observed for the two unloaded conditions, sitting ( p=0.086) and biking ( p=0.338). Loaded conditions produced a significantly greater increase in foot volume compared to unloaded conditions ( p=0.015). Static conditions produced a significantly greater increase in foot volume compared to dynamic conditions ( p=0.005). Conclusions: The results suggest that unloaded positioning resulted in less foot volume increase than loaded positioning. Additionally, dynamic activities resulted in less foot volume increase than static activities. Of the four positions tested, biking resulted in the least amount of volume increase. Therefore, it may be the most appropriate activity when an increase in foot volume may be a concern.

Effect of elastic compression stockings in patients with varicose veins and healthy controls measured by strain gauge plethysmography.

Oedema is one of the most frequent signs of chronic venous insufficiency and may be present at all stages of this disorder. The aim of this study was to compare the effects of four different types of elastic compression stockings on oedema prevention in patients with varicose veins. An increase in foot volume after elevation of the leg was evaluated by strain gauge plethysmography in 20 limbs with varicose veins and 14 normal limbs, and the effects of four different compression stockings--8, 14, 22 and 30-40 mmHg--were compared. All stockings significantly reduced the foot volume increase compared with the no stockings patient group and the normal group. There was no significant difference in the volume increase in the normal group for all four stockings, while there was a significantly smaller volume increase in the 22 mmHg stocking compared to the 14 mmHg stocking in the patient group. Between the 22 mmHg and 30-40 mmHg stockings or between the 14 mmHg and 8 mmHg stockings, there was no significant difference in the volume increase. Elastic stockings, even with a pressure as low as 8 mmHg, can prevent oedema in patients with varicose veins, as well as in normal controls. However, the 22 mmHg and 30-40 mmHg stockings were better at preventing foot oedema in patients with varicose veins than those exerting less compression.

Oedema formation with the vasodilators nifedipine and diazoxide

To determine whether the common side effect of ankle oedema with arteriolar vasodilators such as the calcium entry blocker (CEB) nifedipine and the potassium channel opener (PCO) diazoxide is the direct result of peripheral vasodilation or merely a consequence of renal sodium retention. In 12 healthy sitting volunteers we studied for 3 h the effects of 20 mg nifedipine, 150 mg diazoxide intravenously, 25 mg captopril and placebo on oedema formation and sodium excretion. Foot swelling was determined with a new accurate device (coefficient of variation 0.30%), which uses Archimedes principle to measure water displacement induced by immersion of the foot. Blood pressures were recorded with a Hawksley random-zero sphygmomanometer. All of the active drugs decreased diastolic blood pressure (captopril by 9 +/- 2%, nifedipine by 4 +/- 3% and diazoxide by 2 +/- 2%, compared with an increase of 5 +/- 2% with placebo). Foot volume increased acutely after administration of nifedipine (by 2.6 +/- 0.4%), whereas it remained stable with placebo and the other drugs. Administration of captopril and nifedipine induced increases of fractional sodium excretion (by 20 +/- 9% and 40 +/- 20%, respectively) in contrast to the decreases with placebo and diazoxide (by 13 +/- 11% and 24 +/- 10%, respectively). Only administration of nifedipine induced significant, albeit small, increases in haemoglobin and serum albumin levels. Administration of nifedipine increased foot volume and natriuresis simultaneously, thereby supporting the hypothesis that development of ankle oedema with CEB is a local phenomenon at the site of vasodilation. The absence of a similar increase in foot volume with diazoxide administration should be interpreted with caution because of the rather minor effect of this dose of diazoxide on blood pressure. However, it could be indicative of a different mechanism of oedema formation with PCO.

Assessment of Intermittent Pneumatic Compression by Strain-Gauge Plethysmography

Objective: To compare the physiological effects of a sequential gradient pneumatic compression device (SCD) with a single-chamber pneumatic compression device (Venodyne). Design: Single patient group with treatment crossover. Setting: Department of Surgery, University College and Middlesex Hospital, London, UK. Subjects: Thirty-four limbs of 17 normal adult volunteers were studied. Interventions: Sequential gradient compression was applied to one leg and single-chamber compression to the other lower limb for 10 min. The compression devices were then swapped to the opposite leg for a further 10 min period. Outcome measures: The increase in foot volume (distal venous distension) in response to each compression, and the subsequent decrease in foot volume (distal venous emptying), were measured. The overall reduction of foot volume (net effect) during the period of compression was calculated. Results: The results indicate the net effect was a decrease in foot volume (median decrease 0.35 ml%, 95% CI: 0.21% to 0.45%) with the SCD and no change with the Venodyne (median decrease 0.09 ml%, 95% CI: −0.25% to 0.22%). Conclusion: We conclude that sequential intermittent pneumatic compression of the calf and thigh is less likely to cause distal blood trapping and foot swelling than single-chamber calf compression.

Swelling of the foot, its vascular volume and systemic hemoconcentration during long-term constrained sitting.

Swelling of the left foot and changes in its vascular volume (VV) were studied in seven healthy subjects during 8 h of seated work without leg movements. Changes in total plasma volume (PV) were calculated from hematocrit values. Reference values (r.v.) were obtained during a working day requiring intermittent physical activity (walking). Significant changes during the first 4 h: the foot swelled by 3.5% (r.v.: 2.2%) and VV was reduced by 0.5% of the foot volume (r.v.: increased by 0.3%). Accordingly, the interstitial fluid volume (IFV) of the foot increased by 4.0% (r.v.: 1.9%). The loss of PV was 6.3%. During the last 4 h the only significant change was an increase in foot volume by 1.9%. It is concluded that (1) foot swelling should be corrected for changes in VV to obtain an exact measure of the change in IFV, (2) prolonged elevated pressure, assumed to occur in the feet during relaxed sitting, does not imply distension ("delayed compliance") of the vascular system as previously suggested, (3) hemoconcentration seems to reach complete stability during the initial period of quiet sitting, (4) loss of PV during sedentary work may be avoided by a modest increase in leg activity.

The modification of macrophage activity in experimental granulomas by cyclophosphamide.

Round glass coverslips were implanted in the subcutaneous tissue of mice previously immunized to sheep red cells (SRBC) and the same antigen injected into the pocket where the coverslip lay. It was shown that when mice received a prior dose of cyclophosphamide (Cy) the number of macrophages adherent to the glass increased, they showed more pre-mitotic DNA synthesis and were more phagocytic via their Fc and C3b surface receptors. However, when BCG was inoculated into similar coverslips pockets in mice not previously sensitized to BCG but pre-treated with Cy, the number of macrophages on the glass surface fell and their phagocytic potential decreased compared with non-Cy-treated controls. When BCG was inoculated into the peritoneal cavity of mice, Cy treatment induced a significant increase in the number of lesions in the peritoneal cavity compared with non-Cy treated controls. When BCG was injected into the footpad of mice it was clear that pre-treatment with Cy abolished the increase in foot volume otherwise seen at 24 hr but led to a sustained increase in volume which reached a peak on day 6. However, when Cy was given to the mice 5 days after BCG injection the course of the response was not altered. It is concluded that treatment with Cy before an inflammatory stimulus with an immunological component, modifies macrophage function and granuloma development. Differential effects of Cy on various components of the immune response are thought to be its most likely explanation.

Relationship of antimicrobial cellular immunity to delayed hypersensitivity in Listeriosis.

The relationship of antimicrobial cellular immunity to delayed hypersensitivity (DH) was studied in mice antigenically stimulated by living Listeria monocytogenes confined to diffusion chambers in peritoneal cavities or by subcutaneous inoculation of sublethal doses of the organism. Mice showed DH reactions when tested 6 days after inoculation, and reactions were positive for at least 90 days in some mice. DH also became established when the mice were stimulated by antigens diffusing from peritoneal chambers containing viable Listeria. Mice were categorized as DH positive or DH negative if they developed more or less than a 5% increase in foot volume 24 h after the injection of Listeria antigen. Some antigenically stimulated mice did not elicit the DH reaction. Consequently, the animals were arranged as immunized groups (DH positive and DH negative) and Listeria chamber implant groups (DH positive and DH negative). When challenged with L. monocytogenes, all four groups were significantly resistant as compared with controls. Thus, the in vivo tests for immunity and DH did not show direct correlation. The results suggested that antimicrobial cellular immunity can occur as a phenomenon independent of DH. Evidence for antimicrobial cellular immunity as the principle mechanism of resistance in murine listeriosis is discussed with consideration for possible heterogeneity of function by thymus-derived lymphocytes.