Micro-mobile Foot Compression Device Compared with Pneumatic Compression Device
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
A combination mechanical-pharmacologic regimen is an accepted prophylactic treatment against symptomatic venous thromboembolism for patients undergoing total hip and knee arthroplasties. Foot pumps have been recognized as effective mechanical devices. Research suggests pharmacologic prophylaxis for venous thromboembolism is associated with complications and foot pumps offer an adjunct or alternative approach. Presumably the effectiveness of foot pumps relate to enhancement of venous flow.
We compared an established foot pump system with a new mobile foot pump for their ability to influence mean peak venous velocity in the common femoral, popliteal, and posterior tibial veins.
We evaluated 60 healthy subjects with the established and the novel foot-pump systems. Ultrasonography was used to measure baseline and peak venous velocity with mechanical compression. We constructed 95% confidence intervals (CI) on the mean differences between the two devices to establish equivalence limits. We compared ratios of peak velocity to resting velocity. Subjects subjectively rated the two foot pumps with respect to size, fit, and comfort.
The 95% CI test for equivalence of the mean differences between the two devices was inconclusive. The novel device augmented the venous velocity 11 times greater than the resting velocity in the posterior tibial vein and three times greater than the resting velocity in the popliteal vein. The established foot pump augmented the venous velocity 15 times greater than the resting velocity in the posterior tibial vein and four times greater than the resting velocity in the popliteal vein. The novel device rated better for size, fit, and comfort when compared with the established device.
The established foot pump tended to be associated with greater peak velocities; the novel device produced more consistent mean peak venous velocities and may be more acceptable to patients and caregivers.
Level of Evidence
Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
- Allenby, F, Boardman, L, Pflug, JJ, Calnan, JS (1973) Effects of external pneumatic intermittent compression on fibrinolysis in man. Lancet. 2: pp. 1412-1414 CrossRef
- Anand, S, Theophilus, A (2007) Patient acceptance of a foot pump device used for thromboprophylaxis. Acta Orthop Belg. 73: pp. 386-389
- Anglen, JO, Goss, K, Edwards, J, Huckfeldt, RE (1998) Foot pump prophylaxis for deep vein thrombosis: the rate of effective usage in trauma patients. Am J Orthop (Belle Mead NJ) 27: pp. 580-582
- Bockheim, HM, McAllen, KJ, Baker, R, Barletta, JF (2009) Mechanical prophylaxis to prevent venous thomboembolism in surgical patients: a prospective trial evaluating compliance. J Crit Care. 24: pp. 192-196 CrossRef
- Caschman, J, Blagg, S, Bishay, M (2004) The efficacy of the A-V Impluse system in the treatment of posttraumatic swelling following ankle fracture: a prospective, randomized controlled study. J Orthop Trauma. 18: pp. 596-601 CrossRef
- Chan, JC, Roche, SJ, Lenehan, B, O’sullivan, M, Kaar, K (2007) Compliance and satisfaction with foot compression devices: an orthopaedic perspective. Arch Orthop Trauma Surg. 127: pp. 567-571 CrossRef
- Chow, SC, Shao, J, Wang, H eds. (2008) Comparing means Sample Size Calculations in Clinical Research. Chapman & Hall, Boca Raton, FL
- Colwell, CW, Froimson, MI, Mont, MA, Merrill, RA, Trousdale, RT, Buehler, KC, Spitzer, A, Donaldson, TK, Padgett, DE (2010) Thrombosis prevention after total hip arthroplasty: a prospective, randomized trial comparing a mobile compression device with low-molecular-weight heparin. J Bone Joint Surg Am. 92: pp. 527-535 CrossRef
- Delis, KT, Slimani, G, Hafez, HM, Nicolaides, AN (2000) Enhancing venous outflow in the lower limb with intermittent pneumatic compression: a comparative haemodynamic analysis on the effect of foot vs calf vs. foot and calf compression. Eur J Vasc Endovasc Surg. 19: pp. 250-260 CrossRef
- Fleming, P, Fitzgerald, P, Devitt, A, Rice, J, Murray, P (2000) The effect of the position of the limb on venous impulse foot pumps. J Bone Joint Surg Br. 82: pp. 433-434 CrossRef
- Friedman, RJ (2007) Optimal duration of prophylaxis for venous thromboembolism following total hip arthroplasty and total knee arthroplasty. J Am Acad Orthop Surg. 15: pp. 148-155
- Gardner, AM, Fox, RH (1983) The venous pump of the human foot: a preliminary report. Bristol Med Chir J. 98: pp. 109-112
- Gill, RW (1985) Measurement of blood flow by ultrasound: accuracy and sources of error. Ultrasound Med Biol. 11: pp. 625-641 CrossRef
- Haas, SB, Barrack, RL, Westrich, G, Lachiewicz, PF (2008) Venous thromboembolic disease after total hip and knee arthroplasty. J Bone Joint Surg Am. 90: pp. 2764-2780
- Johanson, NA, Lachiewicz, PF, Lieberman, JR, Lotke, PA, Parvizi, J, Pellegrini, V, Stringer, TA, Tornetta, P, Haralson, RH, Watters, WC (2009) Prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty. J Am Acad Orthop Surg. 17: pp. 183-196
- Kakkos SK, Caprini JA, Geroulakos G, Nicolaides AN, Stansby GP, Reddy DJ. Combined intermittent pneumatic leg compression and pharmacological prophylaxis for prevention of venous thromboembolism in high risk patients. Available at: Cochrane Database of Systematic Reviews 2008, Issue 4. Art. No.: CD005258. DOI: 10.1002/14651858.CD005258.pub2. Accessed May10, 2010.
- Motulsky H. Testing for equivalence or noninferiority. Intuitive Biostatistics: A Nonmathematical Guide to Statistical Thinking. 2nd ed. New York, NY: Oxford; 2010:150–155.
- Pitto, RP, Hamer, H, Heiss-Dunlop, W, Kuehle, J (2004) Mechanical prophylaxis of deep-vein thrombosis after total hip replacement: a randomised clinical trial. J Bone Joint Surg Br. 86: pp. 639-642 CrossRef
- Sculco, TP, Colwell, CW, Pellegrini, VD, Westrich, GH, Bottner, F (2002) Prophylaxis against venous thromboembolic disease in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am. 84: pp. 466-477
- Urayama, H, Tanaka, K, Fukui, D, Kawasaki, S (2003) Increasing circulation in the lower limb under general anesthesia using the A-V Impulse system. Angiology. 54: pp. 691-694 CrossRef
- Vanhoutte, PM, Boulanger, CM, Mombouli, JV (1995) Endothelium-derived relaxing factors and converting enzyme inhibition. Am J Cardiol. 76: pp. 3E-12E CrossRef
- Warwick, D, Harrison, J, Whitehouse, S, Mitchelmore, A, Thornton, M (2002) A randomised comparison of a foot pump and low-molecular weight heparin in the prevention of deep vein thrombosis after total knee replacement. J Bone Joint Surg Br. 84: pp. 344-350 CrossRef
- Westrich, GH, Jhon, PH, Sanchez, PM (2003) Compliance in using a pneumatic compression device after total knee arthroplasty. Am J Orthop. 32: pp. 135-140
- Westrich, GH, Specht, LM, Sharrock, NE, Sculco, TP, Salvati, EA, Pellicci, PM, Trombley, JF, Peterson, M (2000) Pneumatic compression hemodynamics in total hip arthoplasty. Clin Orthop Relat Res. 372: pp. 180-191 CrossRef
- Westrich, GH, Specht, LM, Sharrock, NE, Windsor, RE, Sculco, TP, Haas, SB, Trombley, JF, Peterson, M (1998) Venous haemodynamics after total knee arthroplasty: evaluation of active dorsal to plantar flexion and several mechanical compression devices. J Bone Joint Surg Br. 80: pp. 1057-1066 CrossRef
- White, RH, Zhou, H, Romano, PS (2003) Incidence of symptomatic venous thromboembolism after different elective or urgent surgical procedures. Thromb Haemost. 90: pp. 446-455
- Micro-mobile Foot Compression Device Compared with Pneumatic Compression Device
Clinical Orthopaedics and Related Research®
Volume 469, Issue 6 , pp 1692-1700
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors