title: Venous disease is associated with an impaired range of ankle movement.
abstract: OBJECTIVE
  to investigate the relationship between clinical severity of venous disease, calf muscle pump dysfunction and range of ankle movement (ROAM).
  
  
  METHODS
  ROAM was assessed by goniometry in the supine, nonweightbearing position. Calf muscle pump function was assessed by ambulatory venous pressure (AVP), calculating the pressure relief index (PRI). Venous disease was classified according to the CEAP classification (International Consensus Committee reporting standards on venous disease). Forty seven limbs in 38 adults were recruited and matched for age: 11 normal controls CEAP(0), 12 varicose veins CEAP(2), 12 chronic venous insufficiency CEAP(4,5) and 12 active ulceration CEAP(6).
  
  
  RESULTS
  mean (S.E.M.) age was 60.7 (1.3) years. Mean (S.E.M.) PRI was 1959.6 (313.7) in CEAP(0), 905.3 (139.3) in CEAP(2), 596.5 (148.5) in CEAP(4,5) and 170.6 (69.0) in CEAP(6) (p < 0.001, ANOVA). Mean (S.E.M.) ROAM was 61.3 (2.0) degrees in CEAP(0), but significantly reduced to 49.7 (2.0) in CEAP(2), 42.1 (2.6) in CEAP(4,5) and 40.9 (2.7) in CEAP(6) (p < 0.004, ANOVA post hoc Tukey). PRI correlated with ROAM (p < 0.001, Pearson correlation coefficientr = 0.52).
  
  
  CONCLUSIONS
  limbs with venous hypertension have a reduced range of ankle movement related to the clinical severity of venous disease.
authors.affiliation: Department of Vascular Surgery, South Manchester University Hospitals NHS Trust, Wythenshawe Hospital, Manchester, U.K.
authors.forename: F P
authors.initials: FP
authors.lastname: Dix
authors.forename: R
authors.initials: R
authors.lastname: Brooke
authors.forename: C N
authors.initials: CN
authors.lastname: McCollum
mesh_terms: D000328:Adult; D000842:Ankle / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020820:Dyskinesias / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D018616:Ultrasonography, Doppler, Duplex; D006113:United Kingdom; D014689:Venous Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology