title: Electromuscular stimulation with VEINOPLUS® for the treatment of chronic venous edema.
abstract: OBJECTIVE
  Electromuscular stimulation (EMS) with VEINOPLUS® has recently emerged as a new technique to activate the calf muscle pump, improving the symptoms of venous disease. The aim of the study was to evaluate efficacy of EMS and its impact on evening edema, venous pain, venous outflow and patients quality of life.
  
  
  METHODS
  Thirty patients (32 legs) aged 19-50 (mean 45.2±1.3) classified CEAP C3 with chronic evening venous edema took part in the study (22 limbs: C3, S, Ep, Asp, Pr and 10 limbs: C3, S, Es, Aspd, Pr). All patients were treated with CE-registered VEINOPLUS® neuromuscular stimulator for 30 days. 3 sessions per day (each session lasted for 20 minutes) for the first 10 days, the next 10 days 2 sessions per day and one session per day for the last 10 days. The main evaluated criteria for venous edema was the circumference of the supramaleoal shin segment, measured twice with a tape measure; in the evening the day before and then 5 days after the treatment. All measurements were taken during the interval between 6 and 8 o'clock P.M. All the patients were asked to evaluate venous pain using the Visual Analog Scale, and to fill in a CIVIQ questionnaire (validated for Russian patients) for the Quality Of Life (QOL) measurement. Also venous refilling time (RT) was measured by digital PPG. That was also made twice - before the treatment and in 35 days after the treatment. No other treatments were used.
  
  
  RESULTS
  The EMS treatment was well tolerated by patients. There were no drop outs and patients had no need to change their lifestyles. After the treatment, total or partial reduction of evening edema was shown in 93.8% of limbs, the circumference of the lower leg diminished by 20.3mm (P<0.001), the number of painful legs reduced from 28 to 12 and the severity score of venous pain was cut from 8.3 ±1.1 to 3.8 points ±0.9 (P<0.001), QOL improved significantly as the score dropped from 34.5 ±7.8 to 17.2 points ±4.6 (P<0.001) and RT increased from 17.3 ±0.9 to 21.5 seconds ±1.1 (P<0.001). Three months after VEINOPLUS® treatment, total remission of symptoms was observed in 50% of legs, despite there being no other treatments.
  
  
  CONCLUSIONS
  VEINOPLUS® stimulation is an effective and well-tolerated therapeutic method for the treatment of chronic venous disease. The introduced scheme of EMS application was shown to be useful for treatment of chronic edema, for reducing pain and improving quality of life. It can be used as an additional mean in treatment and to prevent symptoms of CVI. This study also reveals that stimulation of calf muscles with VEINOPLUS® can improve venous outflow and symptoms of CVI. This finding should be investigated and confirmed in further studies.
authors.affiliation: Department of Angiology and Vascular Surgery, Russian State Medical University, Moscow, Russia. vbogachev@comtv.ru
authors.forename: V Y
authors.initials: VY
authors.lastname: Bogachev
authors.forename: O V
authors.initials: OV
authors.lastname: Golovanova
authors.forename: A N
authors.initials: AN
authors.lastname: Kuznetsov
authors.forename: A O
authors.initials: AO
authors.lastname: Shekoyan
authors.forename: N V
authors.initials: NV
authors.lastname: Bogacheva
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004487:Edema / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D010147:Pain Measurement; D017156:Photoplethysmography; D011788:Quality of Life; D012426:Russia; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014689:Venous Insufficiency / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D055815:Young Adult