J Vasc Surg Venous Lymphat Disord. 2013 Apr;1(2):126-33. doi: 10.1016/j.jvsv.2012.07.004. Epub 2012 Dec 17.
Upper body exercise increases lower extremity venous blood flow in deep venous thrombosis.
Journal of vascular surgery. Venous and lymphatic disorders
Kevin Caldwell, Steven J Prior, Meghan Kampmann, Limin Zhao, Sue McEvoy, Andrew P Goldberg, Brajesh K Lal
Affiliations
Affiliations
- Center for Vascular Diagnostics, Division of Vascular Surgery, the University of Maryland School of Medicine, Baltimore, Md.
- Department of Medicine, Division of Gerontology and Geriatric Medicine, the University of Maryland School of Medicine, Baltimore, Md; Veterans Affairs Geriatric Research, Education and Clinical Center, Baltimore, Md.
- Center for Vascular Diagnostics, Division of Vascular Surgery, the University of Maryland School of Medicine, Baltimore, Md; Veterans Affairs Medical Center, Baltimore, Md. Electronic address: [email protected].
PMID: 26992332
DOI: 10.1016/j.jvsv.2012.07.004
Abstract
OBJECTIVE: Sequential compression devices or ambulation prevent deep venous thrombosis (DVT) by enhancing venous blood flow in the lower extremity. However, compression therapy or ambulation may not be possible in patients with lower extremity surgery or trauma. We therefore determined whether upper body exercise increases venous blood flow in the lower extremities as a potential means for preventing DVT.
METHODS: We determined blood volume flow and velocity responses in the common femoral veins to low-intensity (5 W, 75 rpm) upper body cycle ergometry in healthy individuals. Six protocols of single and intermittent bouts of exercise were tested. Upon determination of the most efficacious protocol in these participants, we verified the effects of upper body exercise in patients with acute DVT. Measurements were made before, during, and after exercise using duplex ultrasound imaging.
RESULTS: The study enrolled 15 healthy volunteers (10 men, 5 women; aged 20-40 years) with no history of DVT and 10 patients (aged 31-86 years) with acute DVT. In healthy participants, a single 30-second bout of upper body exercise increased volume flow up to 39% for up to 10 minutes after exercise (P < .05). A single 3-minute bout increased flow to a lesser extent (23% increase; P = .05) for nearly 5 minutes, but a single 1-minute bout did not increase flow. An intermittent protocol of three 30-second bouts of exercise resulted in an increase of 34% to 57% in venous flow (P < .05) for an average increase of 179 ± 53 mL/min. Intermittent 1-minute bouts of exercise tended to increase flow 10% to 40% (P = .06-.08) for an average increase of 149 ± 64 mL/min. Intermittent 3-minute bouts of exercise increased flow 21% to 45% (P < .05) for an average increase of 120 ± 42 mL/min. In patients with acute DVT, the intermittent 30-second upper body exercise protocol increased venous blood flow by 45% to 83% (P < .05) for an average increase of 250 ± 63 mL/min, an effect lasting >13 minutes.
CONCLUSIONS: We report the novel finding that upper body exercise increases lower extremity venous blood flow in healthy volunteers and in acute DVT patients. Three intermittent 30-second bouts of low-intensity upper body exercise elicited the highest response for the least amount of effort and may represent an alternative or adjunct for prophylaxis of DVT in patients with restricted ambulation.
Copyright © 2013 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
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