Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease

Katherine J Williams, Hayley M Moore, Mary Ellis, Alun H Davies Academic Section of Vascular Surgery, Imperial College London, London, UKCorrespondence: Alun H DaviesAcademic Department of Vascular Surgery, 4th Floor, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UKTel +44 20 3311 7320...

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Main Authors: Williams KJ, Moore HM, Ellis M, Davies AH
Format: Article
Language:English
Published: Dove Medical Press 2021-12-01
Series:Vascular Health and Risk Management
Subjects:
Online Access:https://www.dovepress.com/pilot-trial-of-neuromuscular-stimulation-in-human-subjects-with-chroni-peer-reviewed-fulltext-article-VHRM
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author Williams KJ
Moore HM
Ellis M
Davies AH
author_facet Williams KJ
Moore HM
Ellis M
Davies AH
author_sort Williams KJ
collection DOAJ
description Katherine J Williams, Hayley M Moore, Mary Ellis, Alun H Davies Academic Section of Vascular Surgery, Imperial College London, London, UKCorrespondence: Alun H DaviesAcademic Department of Vascular Surgery, 4th Floor, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UKTel +44 20 3311 7320Email a.h.davies@ic.ac.ukIntroduction: Neuromuscular stimulation (NMES) has been shown to improve peripheral blood flow in healthy people. We investigated the effect of bilateral leg NMES on the symptoms of chronic venous disease.Methods: Forty subjects were recruited from four groups: healthy, superficial insufficiency, deep insufficiency, and deep obstruction. Haemodynamic venous measurements were taken from the right femoral vein with ultrasound, laser Doppler fluximetry from the left hand and foot. Devices were then worn for 4– 6 hours per day, for 6 weeks. Haemodynamic measurements were repeated at week 6. Quality of life questionnaires were taken at week 0, 6 and 8.Results: The mean age was 48.7, BMI 28.6kg/m2, and maximum calf circumference 39.0 cm. Twenty-four subjects were men. NMES increased femoral vein peak velocity, TAMV and volume flow by 55%, 20%, 36% at 20 minutes (all p< 0.05), which was enhanced at week 6 (PV and TAMV p< 0.05). Mean increases in arm and leg fluximetry were 71% and 194% (both p< 0.01). Leg swelling was reduced by mean 252.7 mL (13%, p< 0.05) overall; 338.9 mL (16%, p< 0.05) in venous disease. For those with venous pathology, scores for disease specific and generic quality of life questionnaires improved. Those with C4-6 disease benefitted the most, with improvements in VDS score of 1, AVVQ of 6, and SF-12 of 10.Conclusion: NMES improves venous haemodynamic parameters in chronic venous disease, which is enhanced by regular use. NMES reduces leg oedema, improves blood supply to the skin of the foot, and may positively affect quality of life.Clinical Trials: This trial was registered with www.clinicaltrials.org.uk (NCT02137499).Keywords: neuromuscular, electrical, stimulation, venous disease, venous insufficiency
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spelling doaj.art-9b54e64c33e3425a98292591cb78cffd2022-12-21T19:25:13ZengDove Medical PressVascular Health and Risk Management1178-20482021-12-01Volume 1777177871085Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous DiseaseWilliams KJMoore HMEllis MDavies AHKatherine J Williams, Hayley M Moore, Mary Ellis, Alun H Davies Academic Section of Vascular Surgery, Imperial College London, London, UKCorrespondence: Alun H DaviesAcademic Department of Vascular Surgery, 4th Floor, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UKTel +44 20 3311 7320Email a.h.davies@ic.ac.ukIntroduction: Neuromuscular stimulation (NMES) has been shown to improve peripheral blood flow in healthy people. We investigated the effect of bilateral leg NMES on the symptoms of chronic venous disease.Methods: Forty subjects were recruited from four groups: healthy, superficial insufficiency, deep insufficiency, and deep obstruction. Haemodynamic venous measurements were taken from the right femoral vein with ultrasound, laser Doppler fluximetry from the left hand and foot. Devices were then worn for 4– 6 hours per day, for 6 weeks. Haemodynamic measurements were repeated at week 6. Quality of life questionnaires were taken at week 0, 6 and 8.Results: The mean age was 48.7, BMI 28.6kg/m2, and maximum calf circumference 39.0 cm. Twenty-four subjects were men. NMES increased femoral vein peak velocity, TAMV and volume flow by 55%, 20%, 36% at 20 minutes (all p< 0.05), which was enhanced at week 6 (PV and TAMV p< 0.05). Mean increases in arm and leg fluximetry were 71% and 194% (both p< 0.01). Leg swelling was reduced by mean 252.7 mL (13%, p< 0.05) overall; 338.9 mL (16%, p< 0.05) in venous disease. For those with venous pathology, scores for disease specific and generic quality of life questionnaires improved. Those with C4-6 disease benefitted the most, with improvements in VDS score of 1, AVVQ of 6, and SF-12 of 10.Conclusion: NMES improves venous haemodynamic parameters in chronic venous disease, which is enhanced by regular use. NMES reduces leg oedema, improves blood supply to the skin of the foot, and may positively affect quality of life.Clinical Trials: This trial was registered with www.clinicaltrials.org.uk (NCT02137499).Keywords: neuromuscular, electrical, stimulation, venous disease, venous insufficiencyhttps://www.dovepress.com/pilot-trial-of-neuromuscular-stimulation-in-human-subjects-with-chroni-peer-reviewed-fulltext-article-VHRMneuromuscularelectricalstimulationvenous diseasevenous insufficiency
spellingShingle Williams KJ
Moore HM
Ellis M
Davies AH
Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
Vascular Health and Risk Management
neuromuscular
electrical
stimulation
venous disease
venous insufficiency
title Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
title_full Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
title_fullStr Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
title_full_unstemmed Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
title_short Pilot Trial of Neuromuscular Stimulation in Human Subjects with Chronic Venous Disease
title_sort pilot trial of neuromuscular stimulation in human subjects with chronic venous disease
topic neuromuscular
electrical
stimulation
venous disease
venous insufficiency
url https://www.dovepress.com/pilot-trial-of-neuromuscular-stimulation-in-human-subjects-with-chroni-peer-reviewed-fulltext-article-VHRM
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