The Effect of Active Stretching Training in Patients with Chronic Venous Insufficiency Monitored by Raster-Stereography
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Study Population
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- Age > 18 years
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- Bilateral chronic venous insufficiency CEAP clinical classification [3]: C2-3EpAsPr.
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- Previous lower limbs trauma
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- Heart/respiratory/renal insufficiency
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- Use of graduated compression stockings
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- Competitive physical activity
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- Physical activity in the aquatic environment
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- Body mass index > 35
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- Inability to perform any form of physical activity
2.3. Randomization
2.4. Intervention
2.5. Outcome Measurements
2.6. Lower Limb Volumetry
2.7. Air Plethysmography (APG)
2.8. Ankle Range of Motion (ROM)
2.9. Quality of Life (QoL)
2.10. Optoelectronic Body Posture Machine
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- Lordotic angle ITL-ILS max°: the maximum lordotic angle measured between the tangents to the surface of the thoraco-lumbar inflexion point (ITL) and the lower lumbo-sacral inflexion point (ILS).
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- Pelvic tilt in degrees (°): The angle between the line connecting left dimple (DL) and right dimple (DR) and the horizontal.
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- Pelvic tilt (mm): pelvic tilt refers to the difference in height of the sacral dimples (DL-DR).
2.11. Statistical Analysis
3. Results
3.1. Characteristics of the Study Population
3.2. Lower Limb Volume
3.3. Air Plethysmography (APG)
3.4. Ankle ROM
3.5. Quality of Life
3.6. Body Posture Evaluation
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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PHASE 1: RESPIRATORY EXERCISES | |||
Exercise Type | Starting Position | Exercise Performance | Exercise Duration |
Upper thoracic respiration (Figure 1A) | Supine position with legs bent and hands resting on the high chest | Breath-in to expand the upper chest ribs towards the hands. Breath-out completely emptying the chest | 1′ |
Diaphragmatic breathing (Figure 1B) | Supine position with legs bent and hands resting at the level of the navel | Deep breath-in, expanding the abdomen and bringing the navel as high as possible. Breath-out slowly, trying to deflate the abdomen as much as possible. | 1′ |
PHASE 2: VERTEBRAL COLUMN AND PELVIS MOBILIZATION | |||
Exercise Type | Starting Position | Exercise Performance | Exercise Duration |
Antero-retropulsion of the cervical column tract (Figure 1C,D) | Supine position with legs bent and arms to the sides with palms up. | Deep inspiration bringing the chin forward and upwards. Expiration pushing the chin down, trying to flatten the cervical column tract. | 1′ |
Antero and retroversion of the lumbar tract (Figure 1E,F) | Supine position with legs bent and arms to the sides with palms up. | Deep inspiration bringing the pelvis forward against gravity and expiration pushing the pelvis and lumbar tract toward the floor. | 1′ |
PHASE 3: GLOBAL STRETCHING AND CALF PUMP ACTIVATION | |||
Exercise Type | Starting Position | Exercise Performance | Exercise Duration |
Posterior kinetic chain (Figure 1G,H) | Supine position with legs bent and arms to the sides with palms up. | Raise the arms above the head and bring the right knee to the chest. Coordinate inspiration and expiration phase, detaching the shoulders from the floor and pushing the knee to the chest. Repeat with contralateral leg. | 3′ |
Posterior kinetic chain (Figure 1I,J) | Supine position with legs bent and arms to the sides with palms up. | Bring the knees to the chest. From this position lift the legs up, alternating feet dorsiflexion and plantarflexion. | 5′ |
Posterior kinetic chain (Figure 1K,L) | Supine position with legs lying on the ground and arms to the sides with palms up. | Bring the right knee to the chest grabbing it with the hands. Coordinate inspiration and expiration phase pushing the knee to the chest. Repeat with contralateral leg. | 3′ |
Posterior kinetic chain (Figure 1M) | Supine position with legs bent and arms to the sides with palms up. | Bring the knees to the chest grabbing them with the hands. Coordinate inspiration and expiration phase pushing the knee to the chest and alternating feet dorsiflexion and plantarflexion. | 5′ |
Posterior kinetic chain (Figure 1N,O) | Supine position, lower limbs raised from the ground, flexed leaning against the wall, abducted arms at 120° | Extend right limb with the foot in dorsiflexion, sliding with the heel to the wall upwards. Coordinate inspiration and expiration phase pushing the knee to the chest and alternating feet dorsiflexion and plantarflexion. Repeat with contralateral leg. | 5′ |
PHASE 4: “CORE” AND LOWER LIMBS STRENGTHENING | |||
Exercise Type | Starting Position | Exercise Performance | Exercise Duration |
Core (Figure 1P) | Quadruped supine position | Extend right leg and bring up the contralateral arm during expiration. Stay in this position for three complete respirations. Repeat with contralateral | 3′ |
Core (Figure 1Q,R) | Sitting position keeping the feet flat on the floor. Abducted arms. | Breath-in and breath-out bringing the right knee close to the chest. Stay in this position for three complete respirations. Repeat with contralateral | 3′ |
Lower limbs strength (Figure 1S,T) | Lateral decubitus legs bent and 1 arm extended | Breath-out lifting the upper leg. Stay in this position for three complete respirations. Repeat with contralateral | 3′ |
Lower limbs strength (Figure 1U,V) | Lateral decubitus with legs extended. | Breath-out lifting the superior leg. Stay in this position for three complete respirations. Repeat with contralateral | 3′ |
PHASE 5: RELAXATION | |||
Exercise Type | Starting Position | Exercise Performance | Exercise Duration |
Cervical column tract (Figure 1W) | Sitting position | Neck semi-circling | 1′ |
Shoulder (Figure 1X) | Sitting position | Shoulder semi-circling and circling | 2′ |
AGS Exercise Group (10 Patients) | Control Group (10 Patients) | p | |
---|---|---|---|
Age (years) | 62.9 ± 9.7 | 54.5 ± 15.5 | 0.1632 |
Gender (number of males vs. female) | 0 out of 10 | 2 out of 8 | 0.9999 |
BMI | 23.3 ± 1.7 | 24.8 ± 1.7 | 0.2190 |
LEG VOLUME (mL) | 2340 ± 239 | 2419 ± 335 | 0.5496 |
CEAP | 2.7 ± 0.5 | 2.8 ± 0.4 | 0.7481 |
MAIN SYMTOMPS | |||
Heaviness (number of patients out of total) | 10 out of 10 | 10 out of 10 | 0.9999 |
Pain (number of patients out of total) | 10 out of 10 | 10 out of 10 | 0.9999 |
Swelling (number of patients out of total) | 10 out of 10 | 10 out of 10 | 0.9999 |
Throbbing (number of patients out of total) | 7 out of 10 | 8 out of 10 | 0.9999 |
Itching (number of patients out of total) | 6 out of 10 | 7 out of 10 | 0.9999 |
AS Exercise Group | C Group | Reference Value Reported in Literature [16] | |||||
---|---|---|---|---|---|---|---|
T0 | T3 | p | T0 | T3 | p | ||
Lordotic angle ITL-ILS max° | 51.7 ± 10.5 | 46.6 ± 9.2 | <0.01 | 39.3 ± 14.8 | 39.6 ± 14.9 | 0.6043 | 35.45 ± 7.55 |
Pelvic Torsion (DL-DR°) | 4.4 ± 2.2 | 2.5 ± 1.9 | <0.01 | 2.1 ± 2.0 | 2.0 ± 2.2 | 0.3434 | −0.07 ± 2.95 |
Pelvic Tilting (DL-DR mm) | 5.3 ± 3.6 | 3.6 ± 2.8 | <0.04 | 6.3 ± 5.1 | 6.1 ± 5.6 | 0.3434 | −0.12 ± 5.13 |
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Menegatti, E.; Mandini, S.; Pagani, A.; Mandini, B.; Zerbini, V.; Piva, T.; Raisi, A.; Fabbri, M.; Fogli, M.; Mazzoni, G.; et al. The Effect of Active Stretching Training in Patients with Chronic Venous Insufficiency Monitored by Raster-Stereography. Sensors 2022, 22, 8509. https://doi.org/10.3390/s22218509
Menegatti E, Mandini S, Pagani A, Mandini B, Zerbini V, Piva T, Raisi A, Fabbri M, Fogli M, Mazzoni G, et al. The Effect of Active Stretching Training in Patients with Chronic Venous Insufficiency Monitored by Raster-Stereography. Sensors. 2022; 22(21):8509. https://doi.org/10.3390/s22218509
Chicago/Turabian StyleMenegatti, Erica, Simona Mandini, Anselmo Pagani, Beatrice Mandini, Valentina Zerbini, Tommaso Piva, Andrea Raisi, Marinella Fabbri, Marco Fogli, Gianni Mazzoni, and et al. 2022. "The Effect of Active Stretching Training in Patients with Chronic Venous Insufficiency Monitored by Raster-Stereography" Sensors 22, no. 21: 8509. https://doi.org/10.3390/s22218509