Thromb Haemost 2009; 101(06): 1100-1103
DOI: 10.1160/TH08-09-0615
Blood Coagulation, Fibrinolysis and Cellular Haemostasis
Schattauer GmbH

Ankle exercise and venous blood velocity

Paul D. Stein
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
2   Wayne State University School of Medicine, Detroit, Michigan, USA
,
Abdo Y. Yaekoub
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Syed T. Ahsan
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Fadi Matta
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Monisha M. Lala
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Bakhtiar Mirza
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Aaref Badshah
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Mahmud Zamlut
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
,
Dennis J. Malloy
3   Veterans Administration Hospital, Saginaw, Michigan, USA
,
James E. Denier
1   St. Joseph Mercy Oakland Hospital, Pontiac, Michigan, USA
› Author Affiliations
Further Information

Publication History

Received: 26 September 2008

Accepted after major revision: 01 March 2009

Publication Date:
24 November 2017 (online)

Summary

Ankle exercise increases venous blood velocity while supine, but the effect of ankle exercise on venous blood velocity while sitting is not known. In this investigation, we test the hypothesis that venous blood velocity can be increased while sitting by repetitive dorsiflexion of the foot. Time-averaged peak velocity (TAPV) in the popliteal vein of 20 healthy male volunteers was measured by pulsed Doppler ultrasound at rest and during ankle exercise in the supine and sitting positions. Right popliteal vein TAPV while supine at rest was 11 cm/second (sec) (95% confidence interval [CI] =9–13 cm/sec) and with ankle exercise it increased to 24 cm/sec (95% CI =20–28 cm/sec) (p<0.0001). With sitting at rest, right popliteal vein blood TAPV decreased from 11 cm/sec to 3 cm/sec (95% CI = 2–4 cm/sec) (p<0.0001). With ankle exercise while sitting, right popliteal vein TAPV increased to 18 cm/sec (95% CI =15–21 cm/sec) (p<0.0001). In conclusion, in both the supine and sitting positions, ankle exercise increased venous blood velocity, thereby transiently reducing a tendency toward venous stasis. Such ankle exercise might be useful in the prevention of stasis-induced deep venous thrombosis.

 
  • References

  • 1 Geerts WH, Bergqvist D, Pineo GF. et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133: 381S-453S.
  • 2 Urbankova J, Quiroz R, Kucher N. et al. Intermittent pneumatic compression and deep vein thrombosis prevention. A meta-analysis in postoperative patients. Thromb Haemost 2005; 94: 1181-1185.
  • 3 Freedman KB, Brookenthal KR, Fitzgerald Jr RH. et al. A meta-analysis of thromboembolic prophylaxis following elective total hip arthroplasty. J Bone Joint Surg Am 2000; 82: 929-938.
  • 4 Westrich GH, Haas SB, Mosca P. et al. Meta-analysis of thromboembolic prophylaxis after total knee arthroplasty. J Bone Joint Surg Br 2000; 82: 795-800.
  • 5 Lachiewicz PF, Kelley SS, Haden LR. Two mechanical devices for prophylaxis of thromboembolism after total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg Br 2004; 86: 1137-1141.
  • 6 Handoll HH, Farrar MJ, McBirnie J. et al. Heparin, low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures. Cochrane Database Syst Rev 2002; 4: CD000305.
  • 7 Blanchard J, Meuwly JY, Leyvraz PF. et al. Prevention of deep-vein thrombosis after total knee replacement. Randomised comparison between a low-molecular-weight heparin (nadroparin) and mechanical prophylaxis with a foot-pump system. J Bone Joint Surg Br 1999; 81: 654-659.
  • 8 Yang D, Vandongen YK, Stacey MC. Effect of exercise on calf muscle pump function in patients with chronic venous disease. Br J Surg 1999; 86: 338-341.
  • 9 McNally MA, Cooke EA, Mollan RA. The effect of active movement of the foot on venous blood flow after total hip replacement. J Bone Joint Surg Am 1997; 79: 1198-1201.
  • 10 Kwon OY, Jung DY, Kim Y. et al. Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein. Aust J Physiother 2003; 49: 253-258.
  • 11 Homans J. Thrombosis of the deep leg veins due to prolonged sitting. N Engl J Med 1954; 250: 148-149.
  • 12 Symington IS, Stack BH. Pulmonary thromboembolism after travel. Br J Dis Chest 1977; 71: 138-140.
  • 13 Tardy B, Page Y, Zeni F. et al. Phlebitis following travel. Presse Med 1993; 22: 811-814.
  • 14 Simpson K. Shelter deaths from pulmonary embolism. Lancet 1940; 2: 744.
  • 15 Cruickshank JM, Gorlin R, Jennett B. Air travel and thrombotic episodes: the economy class syndrome. Lancet 1988; 2: 497-498.
  • 16 Collins J. Thromboembolic disease related to air travel: what you need to know. Semin Roentgen 2005; 40: 1-2.
  • 17 Ansari MT, Cheung BM, Qing Huang J. et al. Traveler’s thrombosis: a systematic review. J Travel Med 2005; 12: 142-154.
  • 18 Arfvidsson B, Eklof B, Kistner RL. et al. Risk factors for venous thromboembolism following prolonged air travel: a “prospective” study. Vasc Surg 1999; 33: 537-544.
  • 19 Paganin F, Laurent Y, Gauzere BA. et al. Pulmonary embolism on non-stop flights between France and Reunion Island. Lancet 1996; 347: 1195-1196.
  • 20 Ribier G, Zizka V, Cysique J. et al. Venous thromboembolic complications following air travel. Retrospective study of 40 cases recorded in Martinique. Rev Med Interne 1997; 18: 601-604.
  • 21 Eklof B, Kistner RL, Masuda EM. et al. Venous thromboembolism in association with prolonged air travel. Dermatol Surg 1996; 22: 637-641.
  • 22 Mercer A, Brown JD. Venous thromboembolism associated with air travel: a report of 33 patients. Aviat Space Environ Med 1998; 69: 154-157.
  • 23 Parkin L, Bell ML, Herbison GP. et al. Air travel and fatal pulmonary embolism. Thromb Haemost 2006; 95: 807-814.
  • 24 ten Wolde M, Kraaijenhagen RA, Schiereck J. et al. Travel and the risk of symptomatic venous thromboembolism. Thromb Haemost 2003; 89: 499-505.
  • 25 Delis KT, Knaggs AL, Sonecha TN. et al. Lower limb venous haemodynamic impairment on dependency: quantification and implications for the “economy class” position. Thromb Haemost 2004; 91: 941-950.
  • 26 Hitos K, Cannon M, Cannon S. et al. Effect of leg exercises on popliteal venous blood flow during prolonged immobility of seated subjects: implications for prevention of travel-related deep vein thrombosis. J Thromb Haemost 2007; 5: 1890-1895.
  • 27 Schreijer AJ, Cannegieter SC, Caramella M. et al. Fluid loss does not explain coagulation activation during air travel. Thromb Haemost 2008; 99: 1053-1059.
  • 28 Brenner B, Jacob G. “To drink or not to drink”: is this really the question?. Thromb Haemost 2008; 99: 985-986.
  • 29 Macklon NS, Greer IA. Technical note: compression stockings and posture: a comparative study of their effects on the proximal deep veins of the leg at rest. Br J Radiol 1995; 68: 515-518.
  • 30 Macklon NS, Greer IA, Bowman AW. An ultra-sound study of gestational and postural changes in the deep venous system of the leg in pregnancy. Br J Obstet Gynaecol 1997; 104: 191-197.
  • 31 Yamashita K, Yokoyama T, Kitaoka N. et al. Blood flow velocity of the femoral vein with foot exercise compared to pneumatic foot compression. J Clin Anesth 2005; 17: 102-105.
  • 32 Ashby EC, Ashford NS, Campbell MJ. Posture, blood velocity in common femoral vein, and prophylaxis of venous thromboembolism. Lancet 1995; 345: 419-421.