Effects of ankle exercise combined with deep breathing on blood flow velocity in the femoral vein

Abstract

Ankle exercises are commonly used to facilitate venous return in the lower extremity and to prevent deep vein thrombosis. Moreover, the respiratory cycle affects venous return. This study examined the effects of ankle exercise combined with deep breathing on the blood flow velocity in the femoral vein. Twenty healthy males (mean age 21.3 years), who had no medical history of lower extremity disease, were recruited for this study. The blood flow velocity in the femoral vein was measured while performing four exercise protocols: quiet breathing while resting (QR), deep breathing (DB), ankle exercise with quiet breathing (AQB), and ankle exercising combined with deep breathing (ADB). Using a Doppler ultrasound with an 8 MHz probe, peak blood flow velocities were collected for a 20 second period at the start of the inspiration phase in each protocol, three times. There were statistically significant differences in the peak blood flow velocity in the femoral vein with the four protocols (p lt 0.001). The mean (SD) peak blood flow velocity in the femoral vein was as follows: QR 10.1 (4.2) cm/sec, DB 15.5 (3.9) cm/sec, AQB 20.7 (6.6) cm/sec, and ADB 26.5 (9.4) cm/sec. Post hoc analyses revealed significant differences between each of the four protocols (p(adj) lt 0.01). The mean peak blood flow velocity in the femoral vein was greatest with the ADB protocol, which implies that the ADB protocol may be useful to prevent the blood stasis in patients at risk of deep vein thrombosis.

Effects of augmented respiratory muscle pressure production on locomotor limb venous return during calf contraction exercise

“…Our finding that net Q fv in the steady state was not altered by the magnitude of the inspiratory ITP excursion is inconsistent with the findings of Kwon et al (11), who concluded that "deep" diaphragmatic breathing increases steady-state venous return from the locomotor limb. However, these investigators failed to control for changes in venous vessel cross-sectional area and, thus, relied solely on velocimetric estimates of blood flow (11).…”

“…More specifically, previous studies measuring femoral venous blood velocity have suggested that more-negative inspiratory ITP excursions are significant, independent contributors to increases in locomotor limb venous return during exercise in humans (11,21). However, previous work from our laboratory showed that changes in breathing pattern do not appear to contribute significantly to the increases in locomotor limb venous blood flow during calf contraction exercise in the semirecumbent human, although they exert a significant within-breath modulatory effect on femoral venous return (15).…”

“…However, indirect estimates of pulmonary blood flow (2,5), estimates of locomotor limb venous blood flow that did not adequately control for changes in venous vessel cross-sectional area (11,21), confounding effects of changes in arterial CO 2 on local arteriolar tone (6,13), and loosely controlled breathing mechanics have precluded determination of the effects of the augmented inspiratory and expiratory ITP excursions on the return of blood from the locomotor limb to the heart. Also, because in many investigations the subjects were supine (11,21), application of the results to the upright, exercising human is difficult at best (see DISCUSSION).…”

Functional and Psychosocial Effects of Health Qigong in Patients with COPD: A Randomized Controlled Trial

“…38,39 Muscles contractions in harmony with slow breathing facilitate venous return to the heart from the periphery through the ''respiratory muscle pump'' mechanism. 40,41 Meditation involves internalized focus of attention. It produces specific brain-wave patterns (e.g., higher slow a coherence, increases in left-sided anterior activation, etc.…”

Investigating Effect of Nursing Interventions, Based on Wells Score Results, on the Incidence of Deep Vein Thrombosis in Patients Admitted to the Intensive Care Unit

“…Kwon et al's study aimed to investigate the effect of ankle and respiratory exercises on blood flow velocity in the femoral veins. The results showed that the blood flow rate has increased fourfold in the femoral vein after performing ankle exercise and deep breathing simultaneously, which can be used as a method to prevent DVT after orthopedic, heart, or lung surgeries [24]. Furthermore, Memariyan et al's study showed that the incidence of DVT decreased with the simultaneous use of compression elastic stockings and exercise.…”