title: Dynamic ultrasound and treadling: novel approaches to assess and improve lower extremity circulation.
abstract: The purpose of this study was to evaluate the safety and efficacy of a novel treatment of peripheral vascular disease through treadling and to report a dynamic vascular ultrasound technique. After informed consent, 17 volunteers were enrolled in the study. Ultrasound was used to measure  venous and arterial waveforms at the superficial femoral artery and vein in the subject's right thigh during a 5-minute baseline evaluation (resting), a 10-minute treadling period, and a 5-minute cool down period. Comparisons between flow velocities were made during the three trial periods  using a Repeated Measures Mixed Linear Model test with P < 0.05 considered significant. Twenty-six examinations were performed on subjects with an average age of 37 years (range, 25-75 years). Significant increases in maximum and minimum arterial and venous flow velocities  during the treadling time compared with the resting and cool down period were observed (P < 0.0001) with no change in the subjects' vital signs. We found no significant difference in maximum and minimum arterial and venous flow velocities between the resting and cool down period  (P > 0.05). There were no untoward side effects, and all subjects were able to complete the protocol. Low-resistance treadling is safe and improves venous and arterial flow. Dynamic peripheral ultrasonography is a viable technique to assess flow during treadling. Potential future  implications of this study include the evaluation, treatment, and management of lower extremity vascular and chronic diseases and more sensitive peripheral vascular sonography through dynamic ultrasound.
authors.affiliation: South East Area Health Education Center, Department of Surgery, New Hanover Regional Medical Center, Wilmington, North Carolina, USA. william.hope@seahec.net
authors.forename: William W
authors.initials: WW
authors.lastname: Hope
authors.forename: Devan
authors.initials: D
authors.lastname: Griner
authors.forename: David
authors.initials: D
authors.lastname: Weatherford
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Clancy
authors.forename: Laura L
authors.initials: LL
authors.lastname: Currie
authors.forename: James D
authors.initials: JD
authors.lastname: Hundley
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000502:physiology; D005268:Femoral Vein / Q000000981:diagnostic imaging* / Q000502:physiology; D006801:Humans; D016014:Linear Models; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012016:Reference Values; D012039:Regional Blood Flow; D014463:Ultrasonography