title: Acute effects of exercise in patients with previous deep venous thrombosis: impact of the postthrombotic syndrome.
abstract: BACKGROUND
  The postthrombotic syndrome (PTS) occurs frequently after deep venous thrombosis (DVT) and is believed to worsen with upright posture and physical activity. However, the effects of exercise in patients with previous DVT have not been studied.
  
  
  OBJECTIVE
  To determine whether previous DVT and PTS limit the ability to exercise, and whether exercise increases the severity of venous symptoms and signs.
  
  
  METHODS
  A repeated-measures cohort study that was conducted at a university-affiliated teaching hospital, 1999-2000.
  
  
  METHODS
  Subjects with a first episode of unilateral DVT at least 1 year earlier were recruited from the Thrombosis Clinic (total, 41 subjects; with PTS, 19 subjects).
  
  
  METHODS
  Treadmill exercise session.
  
  
  RESULTS
  Venous symptoms, calf muscle fatigability, flexibility, and leg volume before and after treadmill exercise were measured and compared. Exercise did not worsen venous symptoms, despite a higher gain in affected leg volume in subjects with PTS vs subjects without PTS (mean difference: affected leg, 53 mL; unaffected leg, -15 mL; p = 0.018). Calf flexibility significantly improved after exercise in subjects with PTS (gastrocnemius: affected-unaffected, PTS vs no PTS + 4.5 degrees, p = 0.0029; soleus: affected-unaffected, PTS vs no PTS + 5.7 degrees, p = 0.0011).
  
  
  CONCLUSIONS
  Exercise did not acutely exacerbate symptoms and, in subjects with PTS, resulted in improved flexibility in the affected leg. Our findings suggest that treadmill or similar exercise is unlikely to make symptoms of PTS worse, and may improve flexibility. Further study is indicated to determine whether a regular exercise-training program might have a role in the management of patients with PTS, since, to date, the treatment options for this condition are limited.
authors.affiliation: Center for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis Jewish General Hospital, McGill University, Montréal, Canada. susan.kahn@mcgill.ca
authors.forename: Susan R
authors.initials: SR
authors.lastname: Kahn
authors.forename: Laurent
authors.initials: L
authors.lastname: Azoulay
authors.forename: Andrew
authors.initials: A
authors.lastname: Hirsch
authors.forename: Michael
authors.initials: M
authors.lastname: Haber
authors.forename: Carla
authors.initials: C
authors.lastname: Strulovitch
authors.forename: Ian
authors.initials: I
authors.lastname: Shrier
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011186:Postphlebitic Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D011379:Prognosis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*