Electrical foot stimulation and implications for the prevention of venous thromboembolic disease.
BACKGROUND
Venous stasis caused by immobility is an important risk factor for deep vein thrombosis following surgery and lower limb trauma, in bed-ridden medical patients, and in high-risk long distance air travelers. A safe and convenient method for reducing venous stasis would be useful in patients while in hospital and after discharge during their rehabilitation.


METHODS
49 healthy subjects aged 51-76 were seated for 4 hours during which they received mild electrical stimulation of the calf, or sole of the foot (plantar muscles). Popliteal and femoral venous blood flow velocities were measured via doppler ultrasound. The non-stimulated lower extremity served as the simultaneous control. Subjects completed a questionnaire regarding their acceptance and tolerance of the electrical stimulation.


RESULTS
There was a significant increase in venous femoral and popliteal blood flow for both calf (p < 0.035, p < 0.003), and plantar muscles (p < 0.0001, p < 0.009) on the stimulated side compared to the unstimulated side. The magnitude of the effect was similar for calf and plantar muscle stimulation. Subjects did not find the experience uncomfortable, and would use an electrical stimulator if told by their physician that they were at risk for developing blood clots.


CONCLUSIONS
Mild electrical stimulation of the feet, as well as the calf, is a safe effective and convenient method for counteracting venous stasis and therefore has the potential to reduce the risk of deep vein thrombosis and pulmonary embolism for subjects who are immobilized.
Department of Pediatrics, State University of New York, Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, USA. rkaplan@acsu.buffalo.edu
Robert E
RE
Kaplan
James J
JJ
Czyrny
Tat S
TS
Fung
John D
JD
Unsworth
Jack
J
Hirsh
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D004558:Electric Stimulation; D004599:Electric Stimulation Therapy; D005268:Femoral Vein / Q000502:physiology; D005528:Foot / Q000502:physiology*; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D035002:Lower Extremity / Q000098:blood supply / Q000502:physiology; D008875:Middle Aged; D017060:Patient Satisfaction; D011152:Popliteal Vein / Q000502:physiology; D011795:Surveys and Questionnaires; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000209:etiology / Q000517:prevention & control*