Foot sling for the treatment of diurnal leg oedema: effect due to foot muscle pump stimulation?

Summary

Background and objectives: Prospective pilot case series to evaluate the efficacy, tolerability and ease of use of a novel foot sling (Stimfeet) for the treatment of diurnal leg oedema.

Patients and methods: We included 8 female patients with detectable pretibial pitting due to diurnal leg oedema. Hemodynamically relevant reflux or obstruction of the leg veins was ruled out by duplex ultrasonography. The patients wore knee-length medical compression stockings (MCS, 18–23 mmHg) all day for one week and, after a two-day break, used Stimfeet devices (maximum of four hours uninterrupted use) for one week, or vice versa. Before and after each treatment week, two water plethysmographic volume measurements were performed on each leg. Efficacy, tolerability and the ease of use were evaluated by means of a standardised questionnaire. Side effects were documented in a patient diary.

Results: Volume reduction was greater with MCS therapy (mean Δ right leg: 39.00 g, left leg: 24.44 g) than with Stimfeet (mean Δ right leg: 5.06 g, left leg: 2.81 g). However, the difference was not significant (t-test: right leg, p=0.55; left leg, p=0.63). More patients preferred the MCS with respect to reduction of impairment (n=5), comfort (n=6), symptom reduction (n=5), improvement in quality of life (n=5), improvement of working conditions (n=5), and meeting expectations (n=5). The ease of use was rated equally. The most commonly reported side effects of Stimfeet were pressure and chafing marks (n=6), and slip-ping/need for fixation of the device (n=5).

Conclusions: MCS therapy was superior to the novel foot sling for the treatment of diurnal leg oedema. However, the Stimfeet device did lead to an improvement of symptoms and reduced oedema in a few of the patients. Its efficacy possibly depends on the stimulation of the foot muscle pump. Methods of activating the foot muscle pump represent a novel therapeutic option for the treatment of diurnal leg oedema.

Keywords

Leg oedema - compression therapy - foot muscle pump - patient satisfaction - plethysmography

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