Association between heel-rise test performance and clinical severity of chronic venous insufficiency

Abstract

Background Peripheral pump dysfunction is important in identifying manifestations of chronic venous insufficiency. The association with disease severity may define better treatment strategies. Objective To evaluate the association between peripheral muscular pump performance by heel-rise test, age, physical activity, use of compression stockings, and chronic venous insufficiency clinical severity. Methods Subjects with chronic venous insufficiency were enrolled in the study ( n = 172) and evaluated by clinical–etiology–anatomy–pathophysiology severity and heel-rise test. Results In model 1 of logistic regression, number of heel-rise test repetitions, age, and physical activity explained 47% of clinical–etiology–anatomy–pathophysiology severity ( p = 0.0001), physical activity contributed the most. In model 2, heel-rise test repetition rate, age, and physical activity explained 46.4% of clinical–etiology–anatomy–pathophysiology severity ( p = 0.0001), repetition rate contributed the most. Conclusion: There was an inverse association between muscular pump performance and physical activity with clinical–etiology–anatomy–pathophysiology severity, muscular pump repetition rate contributed to a less severe outcome.

Bilateral heel-rise test performance and physiological response are influenced by cadence and ankle position

“…Usualmente, o apoio unipodal tem sido utilizado em avaliações ortopédicas e neurológicas 7 , e o apoio bipodal tem sido utilizado em avaliações cardiovasculares. 8 Segundo Monteiro e colaboradores 2 , o TEC bipodal é mais confiável para avaliação da fadiga muscular, pois minimiza problemas relacionados ao equilíbrio. No entanto, a influência de tais fatores no desempenho e nas alterações fisiológicas induzidas pelo teste ainda é incerta.…”

“…Outros autores também concluíram que o TEC é um teste válido, confiável e de fácil aplicação para avaliação da fadiga muscular periférica. 4,5 Desde então, pesquisadores começaram a investigar a associação do TEC com desfechos clínicos [2][3][4][5]8 e desenvolveram valores de referência. 1,9 No entanto, pouca atenção tem sido dada às alterações fisiológicas que este teste causa.…”

A randomised controlled trial of neuromuscular stimulation in non-operative venous disease improves clinical and symptomatic status

“…41 Additionally, recent work indicates that heel-rise test repetition may have a significant effect on clinical stage of venous disease and this is the exact movement elicited by the NMES in this device. 42 This trial aimed to assess the effect of increasing the "dosage" of NMES treatment, by increasing the duration of use per day from the routine 30 minutes to 60 minutes (1 session to 2 sessions).…”

“… 41 Additionally, recent work indicates that heel-rise test repetition may have a significant effect on clinical stage of venous disease and this is the exact movement elicited by the NMES in this device. 42 …”