A comparison of physical methods for prophylaxis of deep vein thrombosis on augmentation of venous flow velocity and reduction of calf volume

Abstract

Objective: This study was designed to determine the optimal physical methods for promoting venous return of the leg. Methods: Ten healthy volunteers were investigated in the supine position on a couch, and their peak femoral venous velocity and calf muscle volume were determined using duplex ultrasound and strain gauge plethysmography,respectively,before and during deep respiration, limb elevation, calf squeezing and various types of leg exercises. Results: Deep respiration showed the smallest effect on both percentage increase of peak flow velocity and expelled volume. Elevation of the leg showed the same effect on the expelled volume as calf muscle squeezing and ankle movement, while the former showed significantly less effect than the latter on the percentage increase of peak flow velocity. In both dorsal flexion of the ankle and squeezing at the calf, the stronger of each procedure caused more effective changes in haemodynamics. Ankle exercise was more effective in promoting venous return in the calf muscle than wiggling the toes, making circling movements with the feet or alternately flexing and spreading the toes. Conclusions: Ankle exercise or calf muscle squeezing, performed maximally,may be the first recommendation for reducing venous stasis at the calf muscle and prophylaxis of deep vein thrombosis..