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Active Ankle Movements Prevent Formation of Lower-Extremity Deep Venous Thrombosis After Orthopedic Surgery

Ye Li, Xiang-Hong Guan, Rui Wang, Bin Li, Bo Ning, Wei Su, Tao Sun, Hong-Yan Li

(Operation Room, Linyi People’s Hospital, Linyi, Shandong, China (mainland))

Med Sci Monit 2016; 22:3169-3176

DOI: 10.12659/MSM.896911

Published: 2016-09-07

BACKGROUND: The aim of this study was to assess the preventive value of active ankle movements in the formation of lower-extremity deep venous thrombosis (DVT), attempting to develop a new method for rehabilitation nursing after orthopedic surgery.
MATERIAL AND METHODS: We randomly assigned 193 patients undergoing orthopedic surgery in the lower limbs into a case group (n=96) and a control group (n=97). The control group received routine nursing while the case group performed active ankle movements in addition to receiving routine nursing. Maximum venous outflow (MVO), maximum venous capacity (MVC), and blood rheology were measured and the incidence of DVT was recorded.
RESULTS: On the 11th and 14th days of the experiment, the case group had significantly higher MVO and MVC than the control group (all P<0.05). The whole-blood viscosity at high shear rate and the plasma viscosity were significantly lower in the case group than in the control group on the 14th day (both P<0.05). During the experiment, a significantly higher overall DVT incidence was recorded in the control group (8 with asymptomatic DVT) compared with the case group (1 with asymptomatic DVT) (P=0.034). During follow-up, the case group presented a significantly lower DVT incidence (1 with symptomatic DVT and 4 with asymptomatic DVT) than in the control group (5 with symptomatic DVT and 10 with asymptomatic DVT) (P=0.031).
CONCLUSIONS: Through increasing MVO and MVC and reducing blood rheology, active ankle movements may prevent the formation of lower-extremity DVT after orthopedic surgery.

Keywords: Case-Control Studies, Ankle - physiopathology, Female, Follow-Up Studies, Hemorheology, Humans, Incidence, Lower Extremity - physiopathology, Male, Middle Aged, Movement, Orthopedic Procedures - adverse effects, Ultrasonography, Doppler, Venous Thrombosis - prevention & control