A novel exercise device for venous thromboembolism prophylaxis improves venous flow in bed versus ankle movement exercises in healthy volunteers

Abstract

Purpose: Venous thromboembolism prophylaxis is crucial. To facilitate active ankle movement in postoperative and bedridden patients, we developed a novel leg exercise apparatus (LEX). We investigated the effect of the LEX by comparing increases in lower extremity venous flow during different modes of exercise using the LEX. Methods: In eight healthy participants, we measured venous flow volume and velocity in the femoral vein using duplex ultrasonography at 1, 10, 20, and 30 min after completing three modes of 1-min LEX exercises. The exercises involved (1) rapid single motion (ankle dorsi-plantar flexion; 60 cycles/min); (2) slow single motion (30 cycles/min); and (3) slow combined leg motion. Results: Flow volumes after modes 1, 2, and 3 were 1.63-, 1.39-, and 1.53-fold above baseline at 30 min, respectively. Short periods of rapid single motion, with the LEX, improved postexercise lower extremity venous flow volumes at 30 min and mean venous flow velocity at 20 min, compared to slow single motion exercise. Even at slow speeds, combinedmotion improved flow volume compared to single motion. Conclusion: Short periods of rapid single motion exercise, with the LEX, improved postexercise venous flow volumes in the lower extremities at 30 min and mean venous flow velocity at 20 min. These effects were greater than those produced by slow single motion exercises. However, even at slow speeds, combined-motion exercises improved flow volume compared to single motion. Therefore, LEX may prove effective at preventing thromboembolism in postoperative and bedridden patients.

Feasibility and Safety of a Novel Leg Exercise Apparatus for Venous Thromboembolism Prophylaxis After Total Joint Arthroplasty of the Lower Extremities

“…The LEX [18][19][20][21] is a novel device originally developed to perform in-bed lower extremity exercises in patients with impaired mobilization. The device has been designed so that exercises can be performed in a supine position without diminishing the positive effect of ankle plantar exion and dorsi exion on blood ow.…”

“…Therefore, we developed a novel leg exercise apparatus (LEX) to facilitate active leg movement during the early postoperative period [18][19][20][21]. In a previous study on healthy adults, we found that LEX exercising is more effective than IPC alone for improving blood ow [18].…”

Safety of Venous Thromboembolism Prophylaxis Protocol Using a Novel Leg Exercise Apparatus in Bedridden Patients due to Spinal Diseases

“…Although we recommend voluntary lower extremity exercises to prevent VTE, patients with spinal disease rarely perform leg exercises voluntarily. Therefore, we developed a novel leg exercise apparatus (LEX) that helps patients move their lower extremities voluntarily [11][12][13][14]. We found that a brief period of exercise using the LEX increased venous flow in the lower extremities compared with the continuous use of IPCD [12].…”

Effect of Active and Passive Mechanical Thromboprophylaxis and Consensual Effect on the Venous Blood Flow Velocity Among Hemiparetic Patients

“…The active mechanical methods include breathing exercises, 16,17 leg pedal exercises, novel leg exercise apparatus, 18 and venous exercise with the lower limbs. 14,15 Consensual effect can also be added as an increase in the flow of the hemiparetic limb following the active movement of the healthy limb.…”

“…[6][7][8] The components of mechanical prophylaxis are passive techniques: positioning, elevation of the limbs, 9 massage, compression treatments (continuous elastic compression treatment, intermittent pneumatic compression stocking), [10][11][12] electric nerve stimulation, transcutaneous electrical nerve stimulation, 10,13 electrical foot stimulation, 7 electric muscle stimulation, 9 passive movement, and active methods. 14,15 The active mechanical methods include breathing exercises, 16,17 leg pedal exercises, novel leg exercise apparatus, 18 and venous exercise with the lower limbs. 14,15 Consensual effect can also be added as an increase in the flow of the hemiparetic limb following the active movement of the healthy limb.…”