Effectiveness of venous impulsive compression therapy in the reduction of post operative ankle oedema

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Effectiveness of venous impulsive compression therapy in the reduction of post operative ankle oedema


Author: Wong, Chin-wai Sam
Title: Effectiveness of venous impulsive compression therapy in the reduction of post operative ankle oedema
Degree: M.Sc.
Year: 2010
Subject: Hong Kong Polytechnic University -- Dissertations
Pressure suits -- Therapeutic use
Ankle -- Surgery
Edema -- Treatment
Department: Dept. of Rehabilitation Sciences
Pages: xii, 91 leaves : ill. (some col.) ; 30 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2353072
URI: http://theses.lib.polyu.edu.hk/handle/200/5651
Abstract: Background: Presence of oedema after lower limb fracture is one of the major issues that demand special attention in orthopaedic setting. As oedema may lead to pain, compartment syndrome, reduced range of motion and functional impairment, it is of paramount important to optimise oedema control at the early stage of injury. The RICE (Rest, Ice therapy, Compression and Elevation) approach is suggested to be the gold standard in oedema management. Previous studies showed that continuous activation of the foot venous plexus can promote venous blood flow and reduce post-operative lower extremity oedema. Although the association between venous blood flow and oedema control had been established under controlled environment, information relating to its clinical efficacy in post operative conditions is still limited. The primary aim of this study was to investigate the effectiveness of venous impulsive compression therapy (VICT), when incorporated in our oedema management protocol, in the reduction of post-operative ankle oedema. The secondary aim was to evaluate if oedema reduction is associated with improvement of other comobidities such as pain and range of movement at the ankle joint. Method: This was a randomised control study with two-group pretest-posttest design. A total of 21 subjects who had completed ankle surgery were recruited and randomly assigned to the study and control group. 90 minutes of venous foot pump was applied to the subjects in the study group, whereas the control group received compression stocking and elevation regime. Girth and water volumetric measurement for ankle oedema, goniometry measurement for ankle joint ROM and VAS for the level of ankle pain were used as the outcome indicators. Each subjects received 3 assessments: prior to, immediately after and 12 hours after treatment to detennine the immediate and sustainability of treatment effects. Result: The mean (SD) age of subjects was 44.36 (10.72) years in the study group and 48 (10.24) years in the control group. The average (SD) duration of first assessment was 3.63 (2.8) days after operation for the study group and 2.8 (1.0) days for control. The results showed a significant between group improvement in ankle girth (P = 0.007), volume reduction (P = 0.003) and range of motion (P = 0.002) for the study group immediately after treatment. There was no significant between group difference in pain intensity throughout the study. Conclusion: This study was specific to patients who had received ankle operation. Results of this study demonstrated that single application of venous impulsive compression therapy for 90 minutes was more effective than the elevation and compression stocking regime in the reduction of post operative ankle oedema.

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