Physical factors are known to influence haemodynamics in the veins of the lower extremities. In a controlled randomized study we investigated the effects of combined physical therapy on varicose veins.
Over a 24-wk period a treatment group consisting of 12 persons exercised under the activation by means of externally applied compression and cold temperature stimuli (i. e. thermosteresis). They also exercised once a day without supervision for 15min. During the same period a control group of 12 persons underwent the same measurements but no treatment. At baseline and in wk 24 the following measurements were made under standardarized conditions: venous capacity (ml/100ml of tissue) using a strain gauge plethysmograph (Periquant 3800^R, Gutman Eurasburg, FRG); and refilling time of subcutaneous veins emptied by activation of the ankle joint pump using a photoplethysmograph (Cardiopluse Analyzer^R, Fritac Zurich).
In the treatment group venous capacity decreased by an average of 16% from 4.9±0.3 (sd) ml/100ml tissue to 4.1±0.4 (p<0.005, U-test) while in the control group it remained practically unchanged at 4.8±0.4 vs. 5.0±0.3 Venous refilling time in the lower extremities also increased in the treatment group, half refilling rising from 7.8±1.0 to 11.3±0.9 sec (p<0.001) and total refilling time from 17.1±1.4 to 25.7±2.1 (p<0.001); these parameters remained virtually unchanged in the control group, with half refilling time dropping slightly from 7.7±1.1 to 7.1±1.3 and total refilling time from 18.3±1.7 to 16.3±1.9.
Patient self-rating scores obtained using a standardized questionnaire administered at baseline and at the end of wk 24 improved in the treatment group only.
The combined physical therapy was thus shown to be of long-term therapeutic value.
They improved venous function and reduced patients' symptoms. Our findings indicate that for the further development of this combined treatment regimen it would be useful to identify the individual factors contributing to its efficacy and evaluate them separately.