Search Results (14)

Background/Objectives: Intermittent pneumatic impulse compression (IIC) is a well-established drainage treatment that reduces edema and enhances arterial blood flow. While widely utilized in various medical fields, its efficacy in dermatology, particularly for stasis dermatitis, remains underexplored. This study evaluates the effectiveness of IIC in inpatients with bilateral stasis dermatitis by comparing standard therapy alone versus standard therapy with additional IIC on one leg over five days. Methods: Seventeen patients from the Dermatology Department at University Hospital Duesseldorf were enrolled. Both legs received standard therapy, while one randomized leg received additional IIC for four hours daily. Measurements, including transcutaneous oxygen pressure (tcpO₂), leg circumference, and pain sensation, were taken at baseline, the first day post-IIC, and after five days. Statistical analysis included paired t-tests, with significance set at p < 0.05. Results: The IIC-treated legs exhibited significant improvements in tissue oxygen saturation (MD = 19.87 mmHg, SD = 27.82, p = 0.012) and reduced ankle circumference (MD = −2.125 cm, SD = 1.593, p < 0.0001). No significant changes were observed in tcpO₂ or circumference in the non-IIC-treated legs. Other leg circumference measurements (calf, above the knee) did not demonstrate significant improvements in either group. Pain levels remained stable under IIC therapy. Conclusions: This proof-of-concept study provides evidence supporting IIC as a beneficial adjunct therapy for stasis dermatitis, demonstrating significant edema reduction and enhanced oxygenation. Further investigations are warranted to confirm these findings and expand clinical applicability. Full article

Lipedema is a painful disease of subcutaneous adipose tissue (SAT) in women. This study determined whether an advanced pneumatic compression device (APCD) improved lipedema SAT depth, swelling, and pain. Women with lipedema started 20–30 mm Hg compression leggings then were randomized to an APCD (Lympha Press Optimal Plus) group for 30 days (treatment; n = 22) or a no APCD (Control; n = 24) group. APCD treatment significantly reduced left leg volume (3D imaging, LymphaTech; p < 0.043) and fluid in the left (p = 0.0018) and right legs (p = 0.0476; SOZO, bioimpedance spectroscopy); controls showed no change. Treatment significantly decreased extracellular fluid (ECF) and intracellular fluid (ICF) in left (p = 0.0077; p = 0.0060) and right legs (p = 0.0476; p ≤ 0.025), respectively. Only ECF decreased significantly in the left (p < 0.0183) and right legs (p = 0.0009) in controls. SAT depth decreased significantly by ultrasound after treatment at the anterior (p ≤ 0.0234) and medial thigh (p ≤ 0.0052), medial knee (p ≤ 0.0002) and posterior calf (p ≤ 0.0118) but not in controls. All signs and symptoms of lipedema improved in the treatment group including swelling (p = 0.0005) and tenderness (pain) of right (p = 0.0003) and left legs (p < 0.0001); only swelling improved in controls (p = 0.0377). In total, 87.5% of RAND SF-36 quality of life improved after treatment (p ≤ 0.0351) compared to 37.5% in controls (p ≤ 0.0475). APCDs are effective treatment for lipedema. Full article

Background and Objectives: Bedridden patients are at a high risk of venous thromboembolism (VTE). Passive devices such as elastic compression stockings and intermittent pneumatic compression are common. Leg exercise apparatus (LEX) is an active device designed to prevent VTE by effectively contracting the soleus muscle and is therefore expected to be effective in preventing disuse of the lower limbs. However, few studies have been conducted on the kinematic properties of LEX. Therefore, this study aimed to compare the exercise characteristics of LEX with those of an ergometer, which is commonly used as a lower-limb exercise device, and examine its effect on the two domains of muscle activity and circulatory dynamics. Materials and Methods: This study used a crossover design in which each participant performed both exercises to evaluate the exercise characteristics of each device. Fifteen healthy adults performed exercises with LEX and an ergometer (Terasu Erugo, SDG Co., Ltd., Tokyo, Japan) for 5 min each and rested for 10 min after each exercise. Muscle activity was measured using surface electromyography (Clinical DTS, Noraxon, Scottsdale, AZ, USA), and circulatory dynamics were recorded using a non-invasive impedance cardiac output meter (Physioflow Enduro, Manatec Biomedical, Paris, France). The primary outcome was the mean percentage of maximum voluntary contraction (%MVC) of the soleus muscle during exercise. Results: The mean %MVC of the soleus muscle was significantly higher in the LEX group, whereas no significant differences were observed across the periods and sequences. Heart rate, stroke volume, and cardiac output increased during exercise and decreased thereafter; however, the differences between the devices were not significant. Conclusions: LEX may not only have a higher thromboprophylaxis effect, but also a higher effect on preventing muscle atrophy as a lower-extremity exercise device. Additionally, LEX could potentially be used safely in patients who need to be monitored for changes in circulatory dynamics. Full article

Background: Innovative methods of physical therapy delivered via modern medical devices have significantly extended the possibility of applying conservative treatments in healing venous leg ulcers. The primary objective of this study was to compare the therapeutic efficacy of selected mechanical physical therapies (intermittent pneumatic compression vs. radial extracorporeal shockwave vs. focal extracorporeal shockwave) vs. standard care in the treatment of venous leg ulcers over a 4-week period. Materials: This study included 69 patients, comprising 45 females (65%) and 24 males (35%), with a mean age of 67.1 ± 8.6 years (range: from 52.0 to 80.0 years). Methods: The patients were allocated into four groups: the IPC group was treated with intermittent pneumatic compression therapy, the R-ESWT group was treated with radial extracorporeal shockwave therapy, the F-ESWT group was treated with focal extracorporeal shockwave therapy, and the SC group was treated with standard care. Results: After one month of therapy, the median percentage decrease in wound total surface area after treatment was as follows: in the IPC group, there was a 52.9% decrease (range: 3.3–100%); in the R-ESWT group, there was a 31.6% decrease (range: 2.4–95.8%); in the F-ESWT group, there was an 18.0% decrease (range: 1.9–76.1%); and in the SC group, there was a 16.0% decrease (range: 1.5–45.8%). Conclusions: All the studied therapies caused a statistically significant reduction in the surface area of venous leg ulcers. The best results were observed with the intermittent pneumatic compression, while the radial and focal extracorporeal shockwave therapies appeared less effective. The standard care alone turned out to be the least effective. Our results did not show statistically significant changes in the values of RBC deformability at the investigated shear rates. Full article

Total hip arthroplasty (THA) is one of the most successful orthopedic procedures and is highly effective at improving function and quality of life. However, patients commonly experience edema immediately after hospitalization and also after discharge, which can lead to health consequences and a lower quality of life. For these reasons, the aim of this study (NCT05312060) was to evaluate the effectiveness of a specific intermittent leg pneumatic compression on lower limb edema and physical outcomes in patients after total hip arthroplasty, compared to standard conservative treatment. A total of 47 patients were enrolled and randomly allocated into two groups: the pneumatic compression group (PG = 24) and the control group (CG = 23). The CG performed the standard venous thromboembolism therapy, which included pharmacological prophylaxis, compressive stockings, and electrostimulation, while the PG combined pneumatic compression with standard VTE therapy. We evaluated thigh and calf circumferences, knee and ankle ranges of motion, pain, and walking autonomy. Our results showed a greater reduction in thigh and calf circumferences for PG (p < 0.001), while other outcomes were similar for the two groups (p > 0.05). The combination of standard therapy with pneumatic leg compression was more effective at reducing lower limb edema and thigh and calf circumferences than standard treatment. Our results suggest that pressotherapy treatment is a valuable and efficient option for managing lower limb edema after THA. Full article

(1) Background: deep venous thrombosis (DVT) has long been recognized as the most devastating complication after total knee replacement (TKR). To prevent DVT, intermittent pneumatic compression to improve venous return in the lower leg has been advocated by surgeons. Physical activities such as active ankle pumping and early mobilization have been recommended as auxiliary measures to increase venous return in the lower leg and help in ambulation after TKR. In this study, in order to remind patients to exercise their ankle actively and efficiently after TKR, a foot band with motion sensor and reminder alarm was used. (2) Methods: The patients were randomly allocated into three groups according to the therapeutic protocols. The patients in group 1 conducted active ankle pumping without any reminders, those in group 2 underwent intermittent pneumatic compression, and those in group 3 conducted active ankle pumping with ankle motion sensor/reminder. The parameters of blood flow, namely, peak flow velocity and flow volume, in the bilateral common femoral vein and popliteal vein on the 1st, 3rd, and 14th days after surgery were measured using the echo technique, an index to evaluate the effect on promotion of venous return, among the three groups. (3) Results: The peak flow velocity and flow volume of the operative limb in group 3 (with motion sensor/reminder) were significantly higher than those in other groups. The peak flow velocity and flow volume in the popliteal vein in group 3 increased by 112% and 93.8%, respectively, compared to group 1 on the 14th day. No significant difference in peak flow velocity or flow volume was found in the nonoperative limb between the groups. (4) Conclusions: According to the results, a motion sensor/reminder with vibration alarms can improve the performance of active ankle pumping exercises in improving lower leg circulation, and hence may reduce the risk of DVT. Full article

Conventional medical equipment used for treating patients with ischemic heart disease relies on pneumatic compression to achieve intense and instantaneous compression of the legs. Because the pneumatic operation of a compressor inevitably produces noise, the treatment is given to a patient in a separate room to avoid causing discomfort to other patients. This need for a dedicated treatment room could be another source of increased medical costs. In this study, a new electrical motor-driven system was developed to address the noise problem of existing pneumatic compression devices. Additionally, the new system features a reduced footprint and weight, and can be carried by medical staff. To develop a low-noise leg compression machine, the noise level at the surface of the structure was estimated using multibody dynamics simulation. Based on the initial design of the electric leg compression machine, parameters including assembly tolerance, component material, and shape of the structure were adjusted to prepare variations of the initial design, and their noise characteristics were analyzed. It was found that by applying the design variables, the noise levels were reduced by 7.2–11.7% compared with the initial design. The most significant reduction in noise levels was 11.7% and was achieved by reinforcing the section surrounding the gearbox enclosing a noise source. Full article

We conducted a prospective study of cancer patients to investigate the efficacy, quality of life, satisfaction, and safety of a home-based intermittent pneumatic compression (IPC) device during the maintenance phase of lower extremity lymphedema. This device has a unique mode designed to mimic the manual lymphatic drainage (MLD) technique and thereby gently facilitate lymphatic draining of proximal extremities. Thirty patients with stage 3 chronic secondary unilateral leg lymphedema in the maintenance phase underwent IPC and conventional compression therapy for 4 weeks at home. The participants were guided to use 1 h course (30 min of MLD-mimicking mode and 30 min of conventional mode) of IPC device twice a day for 4 weeks. We assessed the patients’ limb-volume measurement, quality of life (QOL), and satisfaction four times. There were no significant time-dependent interactions in the inter-limb volume difference ratio (V_ratio). In a subgroup analysis, participants who used the home-based IPC device and maintained their routine self-maintenance program of short-stretch bandages (group B, n = 21) showed a more significant decline in V_ratio than those who did not maintained their routine care (group A, n = 9). All scores of QOL decreased significantly after the intervention without subgroup difference. All participants were satisfied with the 4-week intervention. This study demonstrated that a home-based IPC device with an MLD-mimicking program is a useful option for maintaining the volume of limbs and improving the QOL of patients with stage 3 chronic leg lymphedema during the maintenance phase. Full article

Pulse wave velocity in veins (vPWV) has recently been reconsidered as a potential index of vascular filling, which may be valuable in the clinic for fluid therapy. The measurement requires that an exogenous pressure pulse is generated in the venous blood stream by external pneumatic compression. To obtain optimal measure repeatability, the compression is delivered synchronously with the heart and respiratory activity. We present a portable prototype for the assessment of vPWV based on the PC board Raspberry Pi and equipped with an A/D board. It acquires respiratory and ECG signals, and the Doppler shift from the ultrasound monitoring of blood velocity from the relevant vein, drives the pneumatic cuff inflation, and returns multiple measurements of vPWV. The device was tested on four healthy volunteers (2 males, 2 females, age $33\pm 13$ years), subjected to the passive leg raising (PLR) manoeuvre simulating a transient increase in blood volume. Measurement of vPWV in the basilic vein exhibited a low coefficient of variation ($3.6\pm 1.1\%$), a significant increase during PLR in all subjects, which is consistent with previous findings. This device allows for carrying out investigations in hospital wards on different patient populations as necessary to assess the actual clinical potential of vPWV. Full article

(1) Purpose: This study aimed to examine whether a pneumatic cuff could promote muscle blood flow and improve muscle stiffness by continuously compressing muscles with air pressure in healthy college students. (2) Method: Twenty-one healthy collegiate students participated in this study. The probe of the near-infrared spectrometer was attached to the upper surface of the left gastrocnemius muscle, and a cuff was wrapped around the left lower leg. The cuff was inflated to 200 mmHg. After 10 min, the cuff was deflated, and the patient rested for 10 min. Muscle stiffness and fatigue were assessed before and after the intervention. (3) Results: During 10 min of continuous compression, StO₂ continued to decrease until seven min of compression. After 10 min of continuous compression, StO₂ was 30.8 ± 10.4%, which was approximately half of 69.2 ± 6.1% at rest. After the release of the pneumatic cuff compression, the StO₂ remained higher than that at rest from 1 to 10 min. Muscle hardness was 19.0 ± 8.0 before intervention was 8.7 ± 4.8 after the intervention. Muscle fatigue was 6.6 ± 1.7 cm before the intervention and 4.0 ± 1.6 cm after the intervention. (4) Conclusions: This study suggests that sustained muscle compression using a pneumatic cuff can promote muscle blood flow and improve muscle stiffness and fatigue. Full article

The prevalence of venous leg ulcers (VLUs) differs between 1.5% and 3% in the general population. The challenge in treating VLUs is common recurrence. Moreover, VLUs can be resistant to healing, despite appropriate treatment. In these cases, advanced wound therapies should be considered. The number of new technologies, applied in VLUs treatment, has increased in the last years. These therapies include biophysical interventions such as ultrasound therapy, electrical stimulations, electromagnetic therapy, or phototherapy. Furthermore, stem cell therapies, biologic skin equivalents, platelet-rich plasma therapy, oxygen therapies, anti-TNF therapy, or negative pressure wound therapy are advanced venous ulcer therapeutic methods that may support the standard of care. Medical devices, such as a muscle pump activator, or intermittent pneumatic compression device, may be especially useful for specific subgroups of patients suffering from VLUs. Some of the above-mentioned technologies require broader evidence of clinical efficacy and are still considered experimental therapies in dermatology. Full article

In this paper, to identify the roof unconfined compressive strength (UCS) in the process of coal mine roadway support in real-time and optimize the real-time drilling speed while drilling, this paper proposes and establishes a drilling test method for assessing the uniaxial compressive strength (UCS) of a roof. This method can be used to optimize the speed of drilling. Moreover, a mathematical model of the power output is developed for a roof-strata identification system with a drilling test system. The results were as follows: (1) the system was able to identify the uniaxial compressive strength of roof rock; (2) the pressure of the drill leg of the pneumatic bolt did not match the output power of the pneumatic motor, the pneumatic motor could not reach the maximum power point, and the insufficient thrust of the pneumatic leg led to failure of the maximum output power of the pneumatic motor; (3) to increase the output power of the air motor and thus improve the drilling speed, we applied a booster valve for the system. The experimental results show that the power of the air motor has a linear relationship with drilling speed. In this way, the speed of the drill can be increased by increasing the motor power. Full article

Currently, 1% of the population of the Western world suffers from venous leg ulcers as a result of chronic venous insufficiency. Current treatment involves the use of moist wound healing, compression bandages, and intermittent pneumatic compression. Neuromuscular electrical stimulation is a novel potential new therapeutic method for the promotion of increased lower limb hemodynamics. The aim of this study was to measure the hemodynamic changes in the lower limb with the use of two neuromuscular electrical stimulation devices. Twelve healthy volunteers received two neuromuscular stimulation device interventions. The Geko^TM and National University of Ireland (NUI) Galway neuromuscular electrical stimulation devices were randomized between dominant and non-dominant legs. Hemodynamic measurements of peak venous velocity (cm/s), the time average mean velocity (TAMEAN) (cm/s), and ejected volume (mL) of blood were recorded. Peak venous velocity was significantly increased by the Geko^TM and the NUI Galway device compared to baseline blood flow (p < 0.0001), while only the voluntary contraction produced significant increases in TAMEAN and ejected volume (both p < 0.05). Neuromuscular muscular electrical stimulation can produce adequate increases in lower limb hemodynamics sufficient to prevent venous stasis. Greater use of neuromuscular stimulation devices could be considered in the treatment of conditions related to chronic venous insufficiency but requires further research. Full article

Patients with leg lymphedema sometimes suffer under constraint feeling leg heaviness and pain, requiring lifelong treatment and psychosocial support after surgeries or radiation therapies for gynecologic cancers. We herein review the current issues (a review of the relevant literature) associated with recently developed diagnostic procedures and treatments for secondary leg lymphedema, and discuss how to better manage leg lymphedema. Among the currently available diagnostic tools, indocyanine green lymphography (ICG-LG) can detect dermal lymph backflow in asymptomatic legs at stage 0. Therefore, ICG-LG is considered the most sensitive and useful tool. At symptomatic stage ≥1, ultrasonography, magnetic resonance imaging-lymphography/computed tomography-lymphography (MRI-LG/CT-LG) and lymphosintiography are also useful. For the treatment of lymphedema, complex decongestive physiotherapy (CDP) including manual lymphatic drainage (MLD), compression therapy, exercise and skin care, is generally performed. In recent years, CDP has often required effective multi-layer lymph edema bandaging (MLLB) or advanced pneumatic compression devices (APCDs). If CDP is not effective, microsurgical procedures can be performed. At stage 1–2, when lymphaticovenous anastomosis (LVA) is performed, lymphaticovenous side-to-side anastomosis (LVSEA) is principally recommended. At stage 2–3, vascularized lymph node transfer (VLNT) is useful. These ingenious procedures can help maintain the patient’s quality of life (QOL) but unfortunately cannot cure lymphedema. The most important concern is the prevention of secondary lymphedema, which is achieved through approaches such as skin care, weight control, gentle limb exercises, avoiding sun and heat, and elevation of the affected leg. Full article