title: Active Ankle Movement May Prevent Deep Vein Thrombosis in Patients Undergoing Lower Limb Surgery.
abstract: BACKGROUND
  Our aim is to investigate the effect of active ankle movement to prevent deep vein thrombosis (DVT) in patients who received lower limb surgery, and to provide a theory of evidence for rehabilitation nursing of patients after orthopedic surgery.
  
  
  METHODS
  Between January 2012 and December 2013, a total of 174 patients were randomized as case group (n = 96) and control group (n = 78). Case group received routine nursing and active ankle movement (30 times/min, 1-7 days after surgery), while control group only received routine nursing. The symptoms and signs of DVT were in real-time observation during the experiment. Thigh and crus circumference, maximum venous outflow (MVO), maximum venous capacity (MVC), and MVO ratio (MVO ratio = MVO/MVC) in the two groups were measured 1-7 days after surgery. Six-month follow-up study was also conducted to observe the occurrence of DVT.
  
  
  RESULTS
  Our study revealed that thigh circumference in the case group decreased compared with the control group in 5-7 days (fifth day: 39.98 ± 3.25 vs. 41.01 ± 3.38, P = 0.043; sixth day: 38.21 ± 3.81 vs. 39.49 ± 3.79, P = 0.029; seventh day: 37.13 ± 3.15 vs. 38.76 ± 3.31, P = 0.001), and crus circumference in the case group also decreased compared with the control group in 5-7 days (fifth day: 26.35 ± 2.11 vs. 27.01 ± 2.19, P = 0.045; sixth day: 25.99 ± 2.31 vs. 26.88 ± 3.12, P = 0.032; seventh day: 25.56 ± 1.99 vs. 26.38 ± 2.89, P = 0.028). MVO and MVC in the case group increased compared with the control group 7 days after surgery (MVO: 15.01 ± 2.56 vs. 14.12 ± 2.56, P = 0.024; MVC: 10.18 ± 3.15 vs. 8.91 ± 2.78, P = 0.006). Significant difference in the incidence of thrombus and DVT were found between the case group and the control group 1-7 days after surgery (thrombus: 1.0% and 7.7%, P = 0.027; DVT: 7.6% and 18.4%, P = 0.032).
  
  
  CONCLUSIONS
  Our result manifested that active ankle movement can relieve the swelling of patients after lower limb surgery, and improve the MVO and MVC of patients to prevent formation of DVT after lower limb surgery.
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, P.R. China. Electronic address: wangzhe_770@126.com.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Ultrasound, Renmin Hospital of Wuhan University, Wuhan, P.R. China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, P.R. China.
authors.forename: Mao
authors.initials: M
authors.lastname: Ye
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, P.R. China.
authors.forename: Guang-Hui
authors.initials: GH
authors.lastname: Shi
authors.affiliation: Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, P.R. China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
mesh_terms: D000842:Ankle / Q000502:physiology*; D002681:China; D004487:Edema / Q000209:etiology / Q000517:prevention & control; D026241:Exercise Movement Techniques; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009068:Movement; D019637:Orthopedic Procedures / Q000009:adverse effects*; D065840:Protective Factors; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*