title: Comparative lower limb hemodynamics using neuromuscular electrical stimulation (NMES) versus intermittent pneumatic compression (IPC).
abstract: Deep Vein Thrombosis (DVT) is a life threatening condition and a serious concern among hospitalised patients, with death occurring in approximately 6% of cases. Intermittent pneumatic compression (IPC) is commonly used for DVT prevention, however suffers from low compliance and issues of usability and portability. Neuromuscular electrical stimulation (NMES) has been shown to improve lower limb hemodynamics but direct comparison with IPC in terms of hemodynamics is rare but very important to determine the potential effectiveness of NMES in DVT prevention.Lower limb IPC was compared to calf NMES, in 30 healthy volunteers (18-23 years). Each intervention was carried out on each leg, on the popliteal vein measured using Doppler ultrasound. All interventions produced significantly greater haemodynamic responses compared to baseline. Calf-IPC and NMES produced significant increases in venous blood velocity (cm/s) and volume of blood ejected per cycle (1 cycle of NMES expels 23.22 ml compared to the baseline ejected volume of 2.52 ml, measured over 1 s (p < 0.001 versues baseline).Improving lower limb hemodynamics is vital in preventing DVT. NMES resulted in larger ejected volumes compared to IPC (x3 greater than foot-IPC and x1.7 greater than calf-IPC) more effectively emptying the veins and soleal sinuses. This is an important finding as DVT occurs predominantly in the soleal sinuses. NMES is silent and portable and thus does not suffer many of the issues associated with IPC. This work supports the potential widespread application of NMES in hospital and home settings where the risk of DVT formation is high.
authors.affiliation: Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland. National Centre for Biomedical Engineering Science, NUI Galway, University Road, Galway, Ireland.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Broderick
authors.forename: Sandra
authors.initials: S
authors.lastname: O'Connell
authors.forename: Shelly
authors.initials: S
authors.lastname: Moloney
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Halloran
authors.forename: James
authors.initials: J
authors.lastname: Sheehan
authors.forename: Fabio
authors.initials: F
authors.lastname: Quondamatteo
authors.forename: Leo R
authors.initials: LR
authors.lastname: Quinlan
authors.forename: Gearoid
authors.initials: G
authors.lastname: OLaighin
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices; D035002:Lower Extremity / Q000098:blood supply / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D011152:Popliteal Vein / Q000000981:diagnostic imaging / Q000502:physiology; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000517:prevention & control; D055815:Young Adult