Neuromuscular stimulation of the common peroneal nerve increases arterial and venous velocity in patients with venous leg ulcers

Das, Saroj; Dhoonmoon, Luxmi; Chhabra, Swati

doi:10.1111/iwj.13510

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…28,29 Activation of the calf muscle pump by means of intermittent NMES of the common peroneal nerve has been shown to augment venous flow in the leg, effectively replicating the effects of exercise, 30 over a prolonged period (in this case 12 hours per day). In patients with venous leg ulcers due to chronic venous insufficiency, venous and arterial flow have been shown to be augmented by NMES, 31 as well as microcirculation and pulsatility in both the wound bed and the wound periphery. 32 Similar effects have been reported in patients with arterial leg ulcers.…”

Section: Discussionmentioning

confidence: 99%

The impact of a new intervention for venous leg ulcers: A within‐patient controlled trial

Bull

Clements

Collarte³

et al. 2023

International Wound Journal

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A major obstacle to the development of new treatments for venous leg ulcers is the difficulty in generating evidence for their effectiveness. Randomised controlled trials using complete healing as the endpoint are seldom powered to be successful, owing to the heterogeneity of cohorts. A novel approach to the evaluation of treatments is presented, using a self-controlled trial model and two metrics of short-term healing rate as alternate endpoints: rate of wound margin advance, and percentage area reduction over 4 weeks. Two different treatment regimens are compared: multi-layer compression alone, versus multi-layer compression combined with activation of the venous leg pump by neuromuscular stimulation. With 60 patients, adding neuromuscular stimulation to multilayer compression resulted in a significant two-fold increase in the rate of wound healing over a 4-week period, both in terms of wound margin advance and in terms of percentage area reduction. The use of these shortterm intermediate endpoint metrics together with a self-controlled study design offers potential for distinguishing between the relative efficacies of interventions more rapidly, with greater sensitivity, and with fewer subjects than a conventional RCT cohort model.

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Section: Discussionmentioning

confidence: 99%

The impact of a new intervention for venous leg ulcers: A within‐patient controlled trial

Bull

Clements

Collarte³

et al. 2023

International Wound Journal

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Effects of low‐frequency pulsed electrical stimulation at the common peroneal nerve on chronic refractory wounds of the lower limb: A randomized controlled trial

Ma,

He,

Gong

et al. 2024

Health Science Reports

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Background and aimsElectrical stimulation (ES) has been shown to substantially enhance the quality of life by alleviating pain in patients with chronic wounds. This study aimed to observe the effects of low‐frequency pulsed wearable ES at the common peroneal nerve on chronic refractory wounds of the lower limb.MethodsForty‐eight participants were randomly divided into control group (n = 24) and treatment group (n = 24) in this study. The control group received standard wound care (SWC) exclusively, whereas the treatment group was administered both SWC and the wearable low‐frequency ES targeting the common peroneal nerve. Measurements of wound area, pain intensity, wound status, and quality of life scores were systematically recorded both before and after 4 weeks treatment.ResultsAfter 4 weeks of intervention, the percentage area reduction was significantly higher in the treatment group compared to the control group (Z = −3.9, p < 0.001), and the healing rate of the treatment group was significantly higher than that of the control group (33% vs. 4%). Moreover, the Visual Analog Scale for Pain score (β = −0.65, p = 0.019), the Bates‐Jensen Wound Assessment Tool score (p < 0.05), and the questionnaire on quality of life with chronic wounds (Wound‐Qol) score (β = −4.23, p = 0.003) were significantly decreased in the patients in the treatment group compared to the control group.ConclusionThe wearable low‐frequency pulsed ES at the common peroneal nerve for the treatment of chronic refractory wounds showed significant improvement and were far superior compared to SWC. Future research should broaden its scope to include a diverse range of wound types and benefit from collaboration across multiple research centers.

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The muscle pump activator device: From evidence to lived experiences

Sibbald,

Geng,

Slomovic

et al. 2024

International Wound Journal

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A chronic wound is one that fails to progress through a normal timely sequence of repair, or in which the repair process fails to restore anatomic and functional integrity after 3 months. The most common chronic wounds include venous, ischaemic and mixed leg ulcers, diabetic foot ulcers and pressure injuries. Chronic wounds place immense physical and psychosocial burden on patients and exact heavy costs for healthcare systems, with many patients continuing to live with chronic wounds even after all management options have been exhausted. The muscle pump activator (MPA) device can be used to bridge this therapeutic gap. By stimulating the common peroneal nerve to activate venous muscle pump of the leg and foot, the MPA device increases blood flow to the lower leg and foot to improve conditions for healing. Currently, evidence in the literature exist to show that the MPA device improves wound outcomes over standard compression therapy, decreases edema and increases wound healing rates. In this review, we also present a series of chronic wound patients treated with the MPA device in multicentre clinics to demonstrate the ability of the MPA device to improve wound outcomes, reduce pain and edema and improve patient quality of life.

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Neuromuscular stimulation of the common peroneal nerve increases arterial and venous velocity in patients with venous leg ulcers

Cited by 4 publications

References 25 publications

The impact of a new intervention for venous leg ulcers: A within‐patient controlled trial

The impact of a new intervention for venous leg ulcers: A within‐patient controlled trial

Effects of low‐frequency pulsed electrical stimulation at the common peroneal nerve on chronic refractory wounds of the lower limb: A randomized controlled trial

The muscle pump activator device: From evidence to lived experiences

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