ABSTRACT
BACKGROUND: Chronic venous insufficiency (CVI) is a common disease that causes calf muscle pump dysfunction and has repercussions for the hemodynamics of the structures involved. OBJECTIVES: To analyze the effects on venous hemodynamics of exercises to strengthen the calf muscles in patients with CVI. METHODS: The study analyzed 25 lower limbs with CVI, classified from C1 to C5 according to the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, in 13 patients recruited from a Lymphedema and Angiodysplasia Clinic at the Hospital Universitário Regional dos Campos Gerais (Brazil). The variables analyzed were collected by isometric dynamometry, goniometry, leg circumference measurement, and adipometry at baseline, after 1 month and 2 months and at the end of the exercise protocol. RESULTS: Dorsiflexion and plantar flexion measurements increased by 5º (p < 0.001). Adipometry detected a reduction in 5 mm (p < 0.001). When grouped by CEAP class, C2 exhibited 5º increases in dorsiflexion (p = 0.02) and plantar flexion (p < 0.001); C3 exhibited a 5ºincrease in dorsiflexion (p = 0.003) and a 1mm reduction in adipometry (p < 0.004); and C1 exhibited a 1.2cm increase in leg circumference (p = 0.04). CONCLUSIONS: Administration of exercise protocols should be considered as a treatment option for CVI, since it has a positive impact on risk factors and on the functions that are impaired by this pathology.
ABSTRACT
Resumo Contexto A insuficiência venosa crônica (IVC) é uma doença comum, uma disfunção da bomba muscular da panturrilha que repercute na hemodinâmica das estruturas. Objetivos Analisar os efeitos dos exercícios de fortalecimento muscular da panturrilha na hemodinâmica venosa em pacientes com IVC. Métodos O estudo contou com a participação de 13 pacientes e 25 membros inferiores com IVC, classificados entre C1 e C5 da classificação Clínica, Etiologia, Anatomia e Fisiopatologia (CEAP), oriundos do ambulatório de cirurgia vascular do Hospital Universitário Regional dos Campos Gerais. As variáveis analisadas foram dinamometria isométrica, goniometria, perimetria, adipometria no início, primeiro mês, segundo mês e final da aplicação do protocolo de exercícios. Resultados Os valores da dorsiflexão e da plantiflexão aumentaram 5º (p < 0,001). Na adipometria notou-se uma redução de 5 mm (p < 0,001). Quando separados em grupos pela CEAP, na C2 houve aumento de 5º na dorsiflexão (p = 0,02) e na plantiflexão (p < 0,001); na C3 houve aumento de 5º na dorsiflexão (p = 0,003) e redução de 1 mm na adipometria (p < 0,004); na C1 houve aumento da perimetria de 1,2 cm (p = 0,04). Conclusões A aplicação de protocolos de exercícios deveria ser considerada como uma forma de tratamento para IVC, pois impacta positivamente em fatores de risco e nas funções que estão deterioradas pela patologia.
Abstract Background Chronic venous insufficiency (CVI) is a common disease that causes calf muscle pump dysfunction and has repercussions for the hemodynamics of the structures involved. Objectives To analyze the effects on venous hemodynamics of exercises to strengthen the calf muscles in patients with CVI. Methods The study analyzed 25 lower limbs with CVI, classified from C1 to C5 according to the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, in 13 patients recruited from a Lymphedema and Angiodysplasia Clinic at the Hospital Universitário Regional dos Campos Gerais (Brazil). The variables analyzed were collected by isometric dynamometry, goniometry, leg circumference measurement, and adipometry at baseline, after 1 month and 2 months and at the end of the exercise protocol. Results Dorsiflexion and plantar flexion measurements increased by 5º (p < 0.001). Adipometry detected a reduction in 5 mm (p < 0.001). When grouped by CEAP class, C2 exhibited 5º increases in dorsiflexion (p = 0.02) and plantar flexion (p < 0.001); C3 exhibited a 5ºincrease in dorsiflexion (p = 0.003) and a 1mm reduction in adipometry (p < 0.004); and C1 exhibited a 1.2cm increase in leg circumference (p = 0.04). Conclusions Administration of exercise protocols should be considered as a treatment option for CVI, since it has a positive impact on risk factors and on the functions that are impaired by this pathology.
