W Man Ivy O, Lepar Gila S, Morrissey Matthew C, Cywinski Jozef K
Centre for Applied Biomedical Research, School of Biomedical Sciences, Shepherd's House, King's College London, London, UK.
Med Sci Sports Exerc. 2003 Apr;35(4):630-4. doi: 10.1249/01.MSS.0000058432.29149.08.
The purpose of this study was to assess whether the increase in foot and ankle volume after 30 min of motionless standing in healthy subjects could be minimized by neuromuscular electrical stimulation (NMES).
A crossover, counterbalanced design was used where foot and ankle volume in 20 healthy subjects was measured using water volumetry before and after 30 min of motionless standing and standing with NMES applied to the lower leg muscles. The NMES produced repeated tetanic contractions of the gastrocnemius and tibialis anterior muscles causing slight ankle dorsi- and plantar-flexion.
Posttest foot and ankle volume was significantly greater than pretest volume after 30 min of motionless standing (t = -7.093, P < 0.001), but no significant differences were found after 30 min of standing with NMES (t = -1.374, P = 0.185). The mean volume changes from pretest to posttest in the conditions without NMES and with NMES were significantly different (51 +/- 32 mL and 12 +/- 39 mL, respectively; t = 3.905, P = 0.001).
This study demonstrates the potential uses of NMES as a means to reduce swelling in the lower limbs for individuals who do not fully activate the musculo-venous pump. The activation of the musculo-venous pump by NMES-induced muscle contraction may have minimized the increase in foot and ankle volume by increasing venous return, reducing venous stasis, increasing lymph flow, and increasing interstitial hydrostatic pressure, which would reduce capillary filtration and assist fluid reabsorption.
本研究旨在评估在健康受试者中，通过神经肌肉电刺激（NMES）能否将静立30分钟后足踝部体积的增加降至最低。
采用交叉、平衡设计，对20名健康受试者在静立30分钟以及对小腿肌肉施加NMES静立30分钟前后，使用水容积法测量足踝部体积。NMES使腓肠肌和胫前肌产生重复强直收缩，引起轻微的踝关节背屈和跖屈。
静立30分钟后，测试后足踝部体积显著大于测试前（t = -7.093，P < 0.001），但在施加NMES静立30分钟后未发现显著差异（t = -1.374，P = 0.185）。在无NMES和有NMES的情况下，从测试前到测试后平均体积变化有显著差异（分别为51±32 mL和12±39 mL；t = 3.905，P = 0.001）。
本研究证明了NMES作为一种手段对于未充分激活肌肉静脉泵的个体减少下肢肿胀的潜在用途。NMES诱导的肌肉收缩激活肌肉静脉泵，可能通过增加静脉回流、减少静脉淤滞、增加淋巴流动以及增加组织间液静水压，从而减少毛细血管滤过并促进液体重吸收，使足踝部体积增加最小化。
