Efficacy of intermittent pneumatic compression in the treatment of oedema comparing calf compression with calf and thigh compression devices

Abstract

Introduction In Germany intermittent pneumatic compression (IPC) to treat oedema is applied only by compressing the calf and thigh. Calf devices are available, but their efficacy was never evaluated. This investigation compared the effectivity of IPC devices only applied to the calf versus those applied to the calf and thigh. The results were expressed as leg volume change and oedema related symptoms.

Methods This was a single centre, investigator initiated, randomised study comparing the efficacy of IPC measuring calf and ankle perimeter electronically and by hand as well as the volume (BT 600, Bauerfeind). Pain scores with visual analogue scales from 0 to 10 were used to evaluate the symptoms. Patients with symmetric lipoedema, phleboedema, lymphoedema, oedema attributed to obesity and other medical causes were all included. Investigation consisted of measuring leg perimeters, volumes and pain scores immediately after standing as well as after 5 minutes of standing without moving. This investigation was performed before and after 30 minutes of IPC. Each patient was treated with a calf device (Venenwalker Basic) on one leg and a calf and thigh device (Lymphamat Gradient 300, Bösl) on the other leg after the sides were randomised.

Results Forty-one patients were randomised, 4 men, 37 women, mean age 47.1 years, mean BMI 30.12 kg/m² (± 5,42), 21 legs “left long” and 20 legs “right long”. Most of the participants had lipoedema (26/41). Both devices achieved a significant volume and perimeter reduction at calf level, no differences were found between both. Pain score were reduced significantly (p < 0.001) by 1.31 points after calf and thigh compression and by 1.27 points after calf compression. No significant differences were found in pain reduction between both devices. A slight tendency towards a delay in the increase of calf volume in the standing position after the treatment was shown for both devices.

Discussion Usually most discomfort and complications in case of oedema are found at the calf, where both devices showed the same volume and pain reduction. Possibly intermittent pneumatic compression applied only to the calf would be enough to reduce oedema symptoms in many cases.

Key words

Intermittent pneumatic compression (IPC) - leg device - volume measurements

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