| 제목 |
Intermittent Pneumatic Compression Reducing Leg Edema and Pain for Prolonged Standing Workers |
| 소속 |
Jeonbuk National University Medical School, Jeonju, 54907, Republic of Korea , Department of Physical Medicine & Rehabilitation1, Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, 54907, Republic of Korea, Research Institute of Clinical Medicine of Jeonbuk National University 2, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea, 3Translational Research & Clinical Trial Center for Medical Device3 |
| 저자 |
Nam-Gyu Jo1,2*, Da-Sol Kim 1,2, Gi-Wook Kim1,2, Sung-Hee Park1,2, Myoung-Hwan Ko1,2, Jeong-Hwan Seo1,2, Yu Hui Won1,2† |
Objective
In long standing positions, the increased hydrostatic pressure in the leg’s blood vessels leads to an increase in transcapillary filtration and a reduction in the reabsorption of tissue fluid, causing an overflow of extravascular fluid in the lower leg and resulting in leg swelling and pain. We investigated the efficacy of mechanical intermittent pneumatic compression (IPC) in long-standing workers with leg edema and pain.
Methods
This crossover designed trial was conducted for healthy long-standing workers (>8 hours daily) with leg edema and pain. Each patient had four different visits and received a 60-minute intervention (IPC using SMA-1000™ or resting) after work with/without a compression stocking (CS). Four groups were established for each visit depending on whether CS was applied during work and whether IPC or resting was applied after work: group A (resting after work without CS), group B (resting after work with CS), group C (IPC after work without CS), and group D (IPC after work with CS). The primary outcome was the visual analogue scale (VAS) score for leg pain. The secondary outcomes were leg circumference and volume and bioimpedance analysis (BIA). Through BIA, extracellular fluid/total body fluid (ECF/TBF) and extracellular water/total body water (ECW/TBW) were measured. All outcomes were assessed before work (T1), after work (T2), and 60 min after intervention (T3).
Results
We included 39 healthy volunteers, aged 30.03±7.56 years who were teachers, nurses, or mart workers. When T1 and T2 were compared, groups A and C (without CS) showed a significant increase in leg volume indicating significant work-induced edema and they showed a significant increase in leg circumference, whereas groups B and D (with CS) showed a significant decrease. The VAS score and leg volume of all groups decreased significantly after the intervention (T3), compared with those after work (T2). In the inter-group comparison between T2 and T3, groups C and D (post IPC) had significantly lower VAS scores than groups A and B in the post hoc analysis (Figure 1), and group C showed a significant reduction in leg volume compared with other groups (Figure 2). In the intra-group comparison between T2 and T3, the leg circumference of groups A, C, and D decreased significantly. In the inter-group comparison, groups C and D showed a more significant improvement in leg circumference than the other groups (Figure 3). The results of ECF/TBF and ECW/TBW showed a more significant edema reduction in groups C and D.
Conclusion
IPC therapy significantly reduced leg pain and edema after work with prolonged standing in healthy adults. |
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Figure 1. Visual analogue scale score. * p<0.05 within-group comparison between T2 and T3, † p<0.008 post hoc analysis between groups A and C, ‡ p<0.008 post hoc analysis between groups B and C, ∫ p<0.008 post hoc analysis between groups A and D, ∫∫ p<0.008 post hoc analysis between groups B and D
Figure 2. Leg volume. * p<0.05 within-group comparison between T2 and T3, † p<0.008 post hoc analysis between groups A and C, ‡ p<0.008 post hoc analysis between groups B and C, ∫ p<0.008 post hoc analysis between groups C and D
Figure 3. Leg circumference. * p<0.05 within-group comparison between T2 and T3, † p<0.008 post hoc analysis between groups B and D, ‡ p<0.008 post hoc analysis between groups B and C, ∫ p<0.008 post hoc analysis between groups A and B, †† p<0.008 post hoc analysis between groups A and C
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