title: Diurnal volume changes of the lower legs in healthy males with a profession that requires standing.
abstract: OBJECTIVE
  The aims of this study are two-fold: To determine intra-individual volume changes of the lower legs in the course of a working day in healthy employees with a standing position at work; to relate complaints of the legs in healthy employees with volume changes in the course of the day.
  
  
  METHODS
  Physical examination and Doppler ultrasound examination were used to exclude the presence of venous disorders. A questionnaire was used to assess complaints of the legs. The lower leg volume was measured with an optical leg volume meter on 2 or 3 days at the beginning and end of a full working day.
  
  
  RESULTS
  Included were 197 male workers with a standing profession and no signs of venous insufficiency. The mean volume change of the lower leg was +1.8% for the left leg and +1.6% for the right leg. This volume increase was significant for both legs (P<0.05). A volume [1 volume unit (VU) is approximately 1 ml] increase of over 50 VU was found in 46% of the legs, mean 141 VU. An unchanged volume (-50 VU to 50 VU) was found VU was found in 18% of the legs, mean -138 VU. Sixty-four percent of the subjects reported subjective complaints of the legs. A tired feeling in the legs, restless legs and a sensation of swelling of the legs were equally present in all three groups of volume change. A statistically significant correlation between pain and a volume decrease was found for the left leg.
  
  
  CONCLUSIONS
  Diurnal volume changes of the lower legs were distributed as a Gaussian curve. A volume increase was common, but not obligatory. A volume increase of the legs was not associated with complaints of the legs or clinically evident oedema. This suggests that a volume increase can be a physiological phenomenon.
authors.affiliation: Department of Occupational Dermatology, Free University Academic Hospital, Amsterdam, The NetherlandsEpidemiology and Biostatistics, Free University Academic Hospital, Amsterdam, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Krijnen
authors.affiliation: Department of Occupational Dermatology, Free University Academic Hospital, Amsterdam, The NetherlandsEpidemiology and Biostatistics, Free University Academic Hospital, Amsterdam, The Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: de Boer
authors.affiliation: Department of Occupational Dermatology, Free University Academic Hospital, Amsterdam, The NetherlandsEpidemiology and Biostatistics, Free University Academic Hospital, Amsterdam, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Ader
authors.affiliation: Department of Occupational Dermatology, Free University Academic Hospital, Amsterdam, The NetherlandsEpidemiology and Biostatistics, Free University Academic Hospital, Amsterdam, The Netherlands.
authors.forename: D P
authors.initials: DP
authors.lastname: Bruynzeel
keywords: leg oedema; leg volume; leg volume measurements; optical leg volume meter; standing profession