The use of a novel in-bed active Leg Exercise Apparatus (LEX) for increasing venous blood flow.
OBJECTIVE
The incidence of pulmonary embolism (PE) and leg deep vein thrombosis (DVT) has increased in recent years in association with aging and an increase in the number of bedridden individuals. We developed an active in-bed leg exercise apparatus labeled the Leg Exercise Apparatus (LEX) for DVT prevention. We compared the effect of leg exercises performed using the LEX to conventional active ankle exercises on increased blood flow.


METHODS
The subjects were eight healthy adult volunteers [five men and three women, aged 20-34 (mean 27.0) years]. Subjects performed two types of exercise; exercise 1 consisted of leg exercises using the LEX, while exercise 2 consisted of in-bed active plantar flexion/dorsiflexion exercises without the device. Measurements were taken 1, 5, 10, 20, and 30 minutes after exercise including common femoral vein blood flow, mean blood flow velocity, maximum blood flow velocity, and vessel diameter using Doppler ultrasound. Statistical procedures included timed measurement data analysis using a linear mixed model. A Bonferroni correction was used for multiple comparisons.


RESULTS
Compared to resting levels, blood flow reached a maximum value 1 minute after exercise for both exercise types, with a significantly greater increase after exercise 1 (1.76-fold increase) compared to exercise 2 (1.44-fold increase) (p = 0.005). There was a significant difference (p = 0.03) between the two exercises for all values from 1 minute to 30 minutes following exercise. There was no significant difference between exercises for peak or mean blood flow velocity. Compared to resting levels, blood vessel diameter reached a maximum value of 1.47-fold greater at 5 minutes post-exercise for exercise 1 and a maximum value of 1.21-fold greater at 1 minute post-exercise for exercise 2.


CONCLUSIONS
Exercise using the LEX increased lower leg venous blood flow and vessel diameter. We propose that the LEX may serve as a new DVT prevention tool.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
Kenta
K
Tanaka
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
Hiroshi
H
Kamada
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan; Department of Rehabilitation Medicine, University of Tsukuba Hospital, Japan.
Yukiyo
Y
Shimizu
Department of Cardiovascular Surgery, University of Tsukuba Hospital, Japan.
Shizu
S
Aikawa
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
Tomofumi
T
Nishino
Department of Orthopaedic Surgery, Kikkoman General Hospital, Japan.
Naoyuki
N
Ochiai
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
Masataka
M
Sakane
Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan.
Masashi
M
Yamazaki
blood flow; exercise; venous thrombosis