Delivery of customizable compressive patterns to human limbs to investigate vascular reactivity

Abstract

ObjectiveCommercial devices for pneumatic compressive treatment of the limbs generally provide predefined stereotyped compressive profiles. The possibility to deliver compressive stimuli with a customizable pressure profile would be useful to differently probe the vascular reactivity to muscle compression (MC) and improve the understanding of MC-induced hyperemia. Aim of this study was the realization of a novel pneumatic system capable of generating adjustable and stable compressive conditions, preceding and following a "standard" MC stimulus Approach A custom-made pneumatic system specifically built to this purpose is tested and characterized in 10 subjects.Three different compressive patterns were delivered to the leg: 1) a constant level: 50 mmHg for 50 s; 2) MC: 200 mmHg for 1 s; 3) a complex profile: 20 mmHg for 50 s, 200 mmHg for 1 s, 50 mmHg for 50 s. Main resultsThe implemented system allowed to deliver graded compressions to the limb characterized by fast transitions (0 to 200 mmHg in 0.5 ± 0.07 s) and stable plateau levels (50.4 ± 0.5 mmHg). SignificanceA new, low-cost, pneumatic prototype has been presented and tested in the present study allowing to deliver compressive stimuli with pre-and post-compressions of adjustable level. This device has been conceived for research purposes and may find application in therapeutic compressive treatments.

A Portable Device for the Measurement of Venous Pulse Wave Velocity

“…Expensive professional machines are generally adopted to the purpose of eliciting rapid tissue compressions [13]. We faced this need when investigating the muscular and skin reactivity to compressive stimuli [14,15], and developed a custom system on the basis of PC-driven valves for controlled rapid inflation and deflation of the cuff [14,16], as recently reviewed [17]. For the present application, a single 3-way valve was adopted for both inflation and deflation.…”

Applications of Intermittent Pneumatic Compression for Diagnostic and Therapeutic Purposes

“…Besides therapeutic treatments, IPC devices can be effectively used to examine in-depth vascular phenomena as hyperemia. Ferraresi et al [11] presented the design and modeling of an IPC device aimed at providing customizable pressure profiles to human limbs, whereas Messere et al [12,13] showed applications of such device on a set of healthy subjects, aimed at developing protocols for the study of the mechanisms behind hyperemia (i.e., the local increase of blood flow to tissues). The device, shown in Fig.…”

“…Resistance vessels in skeletal muscle exhibit a rapid dilatation in response to mechanical stimuli, such as short-lasting external compressions, whose underlying mechanisms are still unclear. Messere et al [12] performed an analysis on 10 healthy volunteers with the IPC device described in the previous section. The subjects sat on a chair with a backrest, the leg fully extended with the cuff wrapped distally to the knee.…”

“…In another application, Ferraresi et al [11] describe a single chamber IPC device with high dynamic performances and capable to apply a customizable pressure pattern to the limbs of the subject. The device is therefore particularly suitable for research purposes oriented to better understand the mechanism behind the hyperemic response that develops in response to compression stimuli and its attenuation following consecutive compressions [12,13]. The same device was also employed in a different application, oriented to the non-invasive assessment of a subject's volemic status [14,15].…”

Design and Simulation of a Novel Pneumotronic System Aimed to the Investigation of Vascular Phenomena Induced by Limb Compression

“…To overcome the limits of commercial devices, a novel pneumo-tronic device based on the application of defined pressure patterns to the limb of a subject with high dynamic performance, so as to allow the investigation of vascular phenomena with appropriate accuracy and precision, has been designed and is presented in this paper. A general description of the device architecture has been already presented in [23], in which the Authors focused on a clinical application concerning the study of vascular reactivity to an external compression exerted by a pressure-controlled pneumatic cuff. A preliminary characterization of the system has been presented in [24], considering only a limited working condition (step pressure reference signal, 50 mmHg of amplitude).…”