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Neuromuscular electrostimulation via the common peroneal nerve promotes lower limb blood flow in a below-knee cast: a potential for thromboprophylaxis

Neuromuscular electrostimulation via the common peroneal nerve promotes lower limb blood flow in a below-knee cast: a potential for thromboprophylaxis
Neuromuscular electrostimulation via the common peroneal nerve promotes lower limb blood flow in a below-knee cast: a potential for thromboprophylaxis
Objectives: we aimed to examine the characteristics of deep venous flow in the leg in a cast and the effects of a wearable neuromuscular stimulator (geko; FirstKind Ltd) and also to explore the participants’ tolerance of the stimulator.

Methods: this is an open-label physiological study on ten healthy volunteers. Duplex ultrasonography of the superficial femoral vein measured normal flow and cross-sectional area in the standing and supine positions (with the lower limb initially horizontal and then elevated). Flow measurements were repeated during activation of the geko stimulator placed over the peroneal nerve. The process was repeated after the application of a below-knee cast. Participants evaluated discomfort using a questionnaire (verbal rating score) and a scoring index (visual analogue scale).

Results: the geko device was effective in significantly increasing venous blood flow in the lower limb both with a plaster cast (mean difference 11.5 cm/sec-1; p = 0.001 to 0.13) and without a plaster cast (mean difference 7.7 cm/sec-1; p = 0.001 to 0.75). Posture also had a significant effect on peak venous blood flow when the cast was on and the geko inactive (p = 0.003 to 0.69), although these differences were less pronounced than the effect of the geko (mean difference 3.1 cm/sec-1 (-6.5 to 10)). The geko device was well tolerated, with participants generally reporting only mild discomfort using the device.

Conclusion: the geko device increases venous blood flow in the lower limb, offering a potential mechanical thromboprolylaxis for patients in a cast
179-185
Warrick, D.J.
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Shaikh, A.
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Gadola, Stephan D.
ef2fa6cf-2ccc-4fea-a7a5-cc03a9d13ab1
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Worsley, Peter
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Bain, D.
f7a8aa36-3401-4911-b7d9-61215b2859ba
Tucker, A.
903f853e-d437-4f46-bb04-73b69fbd5b24
Warrick, D.J.
91df059d-39e1-4560-bc94-a4f03f75f5c4
Shaikh, A.
1c8ce619-4e4f-4aff-b104-d6a7ac32d1cd
Gadola, Stephan D.
ef2fa6cf-2ccc-4fea-a7a5-cc03a9d13ab1
Stokes, M.
71730503-70ce-4e67-b7ea-a3e54579717f
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Bain, D.
f7a8aa36-3401-4911-b7d9-61215b2859ba
Tucker, A.
903f853e-d437-4f46-bb04-73b69fbd5b24

Warrick, D.J., Shaikh, A., Gadola, Stephan D., Stokes, M., Worsley, Peter, Bain, D. and Tucker, A. (2013) Neuromuscular electrostimulation via the common peroneal nerve promotes lower limb blood flow in a below-knee cast: a potential for thromboprophylaxis. Bone & Joint Research, 2 (9), 179-185. (doi:10.1302/2046-3758.29.2000176). (PMID:23999610)

Record type: Article

Abstract

Objectives: we aimed to examine the characteristics of deep venous flow in the leg in a cast and the effects of a wearable neuromuscular stimulator (geko; FirstKind Ltd) and also to explore the participants’ tolerance of the stimulator.

Methods: this is an open-label physiological study on ten healthy volunteers. Duplex ultrasonography of the superficial femoral vein measured normal flow and cross-sectional area in the standing and supine positions (with the lower limb initially horizontal and then elevated). Flow measurements were repeated during activation of the geko stimulator placed over the peroneal nerve. The process was repeated after the application of a below-knee cast. Participants evaluated discomfort using a questionnaire (verbal rating score) and a scoring index (visual analogue scale).

Results: the geko device was effective in significantly increasing venous blood flow in the lower limb both with a plaster cast (mean difference 11.5 cm/sec-1; p = 0.001 to 0.13) and without a plaster cast (mean difference 7.7 cm/sec-1; p = 0.001 to 0.75). Posture also had a significant effect on peak venous blood flow when the cast was on and the geko inactive (p = 0.003 to 0.69), although these differences were less pronounced than the effect of the geko (mean difference 3.1 cm/sec-1 (-6.5 to 10)). The geko device was well tolerated, with participants generally reporting only mild discomfort using the device.

Conclusion: the geko device increases venous blood flow in the lower limb, offering a potential mechanical thromboprolylaxis for patients in a cast

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More information

Published date: 11 July 2013
Organisations: Faculty of Medicine, Engineering Science Unit

Identifiers

Local EPrints ID: 356563
URI: http://eprints.soton.ac.uk/id/eprint/356563
PURE UUID: 9efdf12d-201b-494c-9e09-1cf6f03734a6
ORCID for M. Stokes: ORCID iD orcid.org/0000-0002-4204-0890
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042

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Date deposited: 19 Sep 2013 07:43
Last modified: 09 Jul 2020 00:31

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Contributors

Author: D.J. Warrick
Author: A. Shaikh
Author: Stephan D. Gadola
Author: M. Stokes ORCID iD
Author: Peter Worsley ORCID iD
Author: D. Bain
Author: A. Tucker

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