The effect of intermittent pneumatic compression on the bone uptake of (99m)Tc-labelled methylene diphosphonate in the lower limb

Venous tonus enhancement after a short cycle of intermittent pneumatic compression

Objectives

To test if intermittent pneumatic compression (IPC) used with a short cycle could reproduce and confirm the 30 min vasoconstriction effect observed after a long cycle of pressure.

Methods

Eighteen subjects took part in the study, 12 with venous insufficiency (VI) and six without VI (NonVI). Duplex scanner was used to evaluate the diameter of six sites of veins on each of both lower limbs before and after the treatment. The IPC was applied to only one limb.

Results

The control limb showed no change in venous diameter. The treated limb, showed in the NonVI group one vasoconstriction: the greater saphena at the knee level (GS) ( P < 0.05). In the VI group, four sites out of six showed a vasoconstriction: the common femoral ( P < 0.005), the GS at its cross ( P < 0.001), the GS ( P < 0.001) and the lesser saphena ( P < 0.05).

Conclusions

Both long and short cycle of IPC are suitable to enhance the venous tone in VI patients for at least 30 min after the end of the treatment.

Intermittent pneumatic compression in fracture and soft-tissue injuries healing

INTRODUCTION

Current methods of fracture care use various adjuncts to try and decrease time to fracture union, improve fracture union rates and enhance functional recovery. Intermittent pneumatic compression (IPC), one such modality, is used in the management of both fractures and soft-tissue injuries.

METHODS AND RESULTS

A search of PubMed, Medline, CINAHL, DH data and Embase databases was performed using the following keywords 'intermittent pneumatic compression', 'fracture healing' and 'soft tissue healing'. Sixteen studies on the use of IPC in fracture and soft-tissue healing were identified. These studies demonstrated that IPC facilitates both fracture and soft-tissue healing with rapid functional recovery.

CONCLUSIONS

IPC appears to be an effective modality to enhance fracture and soft-tissue healing. However, the number of subjects in human studies is small, and adequately powered randomized controlled trials in humans are required to produce stronger clinically relevant evidence.

Effect of intermittent compression therapy on bone mineral density in women with low bone mass

Intermittent pneumatic compression has been shown to increase blood flow in the leg which, in turn, may improve BMD. We performed a pilot study to assess whether intermittent compression of the leg could improve BMD at the femoral neck. 37 postmenopausal women with low bone density T score < -1 at either hip or spine were recruited into the study of whom 24 completed. Women applied intermittent compression for 2 h a day for 6 months to each leg in turn. The study lasted 1 year. Women were also given daily 1 g of Calcium and 800 IU of vitamin D (Calcichew D 3 forte Shire, UK). Lumbar spine BMD decreased by 0.5% at 12 months compared with baseline (mean difference 0.005 g/cm(2), 95% C.I -0.2287 to 0.03459, P = 0.28). At 12 months the right femoral neck BMD increased by 3% compared with baseline (mean 0.811 +/- 0.08, P = 0.22), while the left increased 2% (0.783 +/- 0.06, P = 0.16). There was no change in BMD at the distal tibia or heels and no site effect of the compression. The fat mass decreased by 4.6% in the right leg and 5% in the left leg (P = 0.005 and 0.003, respectively). Tissue thickness did not change. The analysis of the interaction between the degree of exercise and change in BMD showed a statistically significant increase in right femoral neck BMD following 6 months of right leg intermittent compression, but only in women whose exercise was minimal (P = 0.029). This effect was not seen in the left femur possibly due to the reduced number of patients who completed the study in this group. These preliminary results indicate that intermittent pneumatic leg compression may have a role in osteoporosis prevention. It may provide a mean of inhibiting decline in femoral neck BMD, particularly in sedentary women.