title: Randomised Controlled Trial: Potential Benefit of a Footplate Neuromuscular Electrical Stimulation Device in Patients with Chronic Venous Disease.
abstract: Chronic venous disease (CVD) is common, affecting a quarter of the population. Current conservative methods of treatment aim to prevent progression of disease by reducing ambulatory venous pressure. Neuromuscular electrical stimulation (NMES) refers to the use of electrical impulses to elicit muscle contraction. This pilot randomised controlled trial investigates the effect of a footplate NMES device (REVITIVE) on venous flow parameters, limb oedema, and quality of life outcome measures in patients with CVD.
  
  
  
  Twenty-two patients with Clinical Etiological Anatomical and Pathophysiological (CEAP) clinical class C2-C4 venous disease were randomised to receive a sham or test device. The recommended duration of use was for 30 minutes daily for 6 weeks. Venous flow parameters (duplex ultrasound), limb volume (optoelectric volumeter), and quality of life outcome measures were measured at baseline and after 6 weeks.
  
  
  
  The mean age of participants was 62 years, body mass index 28.6, with a 15:7 female preponderance. There was a significant difference in the percentage change in femoral vein flow parameters (from baseline) between the test and sham group while using the device (Week 0 time-averaged mean velocity 102.4% vs. -9.1%, p < .0001; volume flow 107.9% vs. -3.7%, p < .0001; peak velocity 377.7% vs. -6.7%, p < .0001). Limb volume was observed to increase significantly in the sham group (2.0% at Week 0 and 1.2% at Week 6; p < .01). This was prevented in the test group (+0.8% at Week 0 and 1.0% at Week 6; p = .06). There was a significant difference in the Aberdeen Varicose Vein Questionnaire between the two groups over the 6 weeks.
  
  
  
  This trial demonstrated a significant difference in venous flow parameters and prevention of orthostatic limb oedema with NMES. There was a positive effect on quality of life. Larger studies are required to determine the clinical significance of this in patients with venous disease.
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK. Electronic address: r.ravikumar@imperial.ac.uk.
authors.forename: R
authors.initials: R
authors.lastname: Ravikumar
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Williams
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Babber
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: T R A
authors.initials: TRA
authors.lastname: Lane
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Moore
authors.affiliation: Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, UK.
authors.forename: A H
authors.initials: AH
authors.lastname: Davies
mesh_terms: D000368:Aged; D002908:Chronic Disease; D004487:Edema / Q000517:prevention & control; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005268:Femoral Vein / Q000502:physiology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000098:blood supply / Q000502:physiology; D010349:Patient Compliance; D010865:Pilot Projects; D011788:Quality of Life; D012039:Regional Blood Flow; D014652:Vascular Diseases / Q000628:therapy*
keywords: Neuromuscular electrical stimulation; Oedema; Quality of life; Venous disease; Venous flow parameters