在不同下肢姿势下，通过腓总神经进行神经肌肉刺激可增强足部微循环：一种治疗腿部溃疡的潜在方法。

Microcirculation in the foot is augmented by neuromuscular stimulation via the common peroneal nerve in different lower limb postures: a potential treatment for leg ulcers.

作者信息

Warwick D, Shaikh A, Worsley P, Gadola S, Bain D, Tucker A, Gadola S D, Stokes M

机构信息

Musculoskeletal Research Unit, University of Southampton, University Hospital of Southampton, Southampton, UK -

出版信息

Int Angiol. 2015 Apr;34(2):158-65.

PMID:25839841

Abstract

AIM

Aim of the study was to examine the effects of the geko™ device (a portable electical nerve stimulator) on microcirculatory flow on the dorsum of the foot, and whether this is influenced by lower limb postures and application of a plaster cast.

METHODS

This was a cross-sectional, healthy cohort, open label, physiological response study. In 10 healthy volunteers, aged 19 to 24 years, laser Doppler fluxmetry measurements were made on the dorsum of the foot in four postures: standing (weight bearing and non-weight bearing) and supine lying (with the lower limb horizontal and then elevated). Measurements of flux were made both at rest and during stimulation with the geko™ device applied over the common peroneal nerve, at 1 Hz for 5 minutes in each posture. Repeat measurement were made after the application of a below knee plaster cast. Measures of flux were compared to basal levels assumed to be in supine with limb horizontal, with no cast and an inactive geko™ device.

RESULTS

The geko™ device was effective in increasing microcirculation on the dorsum of the foot in all four postures (mean difference =141%, 95% CI 70%-212%, P=0.001). This effect was more pronounced than that of using a plaster alone (Mean increase in flux of 73%, 95% CI 22%-125%, P=0.01) or variances due to the hydrostatic effects of different postures (mean difference 17-27.6%, P>0.05). There was a 2 to 3 fold increase in flux when stimulation was delivered in combination with the plaster cast.

CONCLUSION

Stimulation using the geko™ device augments microcirculation in the foot. The response is greater in lying and non-weight bearing than weight bearing standing but the most striking effect is when stimulation is combined with a plaster cast. The geko™ offers a potential means of promoting conditions favourable for wound healing, where treatment using compression may be contraindicated, such as arterial/mixed aetiology ulcers.

摘要

目的

本研究旨在探讨geko™设备（一种便携式电神经刺激器）对足背微循环血流的影响，以及这是否受下肢姿势和石膏固定的影响。

方法

这是一项横断面、健康队列、开放标签的生理反应研究。对10名年龄在19至24岁的健康志愿者，在四种姿势下对足背进行激光多普勒血流测量：站立（负重和非负重）和仰卧位（下肢水平然后抬高）。在静息状态以及在腓总神经上应用geko™设备进行刺激时进行血流测量，每种姿势下以1Hz频率刺激5分钟。在应用膝下石膏后进行重复测量。将血流测量值与假定为下肢水平仰卧位、无石膏且geko™设备未激活时的基础水平进行比较。

结果

geko™设备在所有四种姿势下均能有效增加足背的微循环（平均差异=141%，95%置信区间70%-212%，P=0.001）。这种效果比单独使用石膏更明显（血流平均增加73%，95%置信区间22%-125%，P=0.01），也比不同姿势的流体静力效应导致的差异更明显（平均差异17%-27.6%，P>0.05）。当刺激与石膏固定联合应用时，血流增加2至3倍。