Effect of elastic compression stockings on venous hemodynamics in hemiplegic patients.
Unilateral lower extremity edema and an increased risk of thromboembolism have been associated with hemiplegia following stroke. This study was undertaken to determine the effect of knee-high, graded elastic stockings on venous hemodynamics in hemiplegic patients. Thirty-six patients with recent cerebral infarcts were studied. The presence of underlying venous or arterial occlusive disease was excluded in all patients. Duplex scanning techniques were used to measure femoral and popliteal venous circumference, cross-sectional area, and peak flow velocity in the normal and paralyzed extremities both with and without stockings. All patients were examined and assessed for the degree of motor weakness and Brunnstrom stage of recovery. Associated medical illnesses were also reviewed. These patients were found to have a decreased flow in the femoral (p = 0.0002) and popliteal (p = 0.006) veins and an increase in the femoral vein size. The application of compression stockings resulted in a significant increase in venous size and flow velocity in both areas. The femoral and popliteal velocity correlated inversely with the degree of motor impairment and Brunnstrom stage, suggesting that factors other than the muscle pump may be responsible for the augmentation of femoral flow velocity in the paralyzed leg. There was no correlation demonstrated with other variables such as age, gender, cardiovascular disease, or diabetes. These results would indicate a potential benefit of graded knee-high elastic compression stockings in reducing venous flow stasis in hemi-paretic patients.
From the Departments of Medicine, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.; The Departments of Physical Medicine and Rehabilitation, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.
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Sioson
The Departments of Surgery, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.
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Alexander
From the Departments of Medicine, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.; The Departments of Physical Medicine and Rehabilitation, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.
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Mentari
The Departments of Surgery, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.
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Heitz
From the Departments of Medicine, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.; The Departments of Physical Medicine and Rehabilitation, Case Western Reserve University and Metro Health Medical Center, Cleveland, OH, U.S.A.
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Mion