<strong>Background and Purpose:</strong> Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older...<strong>Background and Purpose:</strong> Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affect their quality of life (QOL) and restrict their personal independence and participation. This study aimed to determine the effect of intermittent pneumatic compression (IPC) on lower leg pain, walking capacity, functional mobility, ankle range of motion (AROM), and QOL of community-dwelling older people with walking difficulties. <strong>Methods:</strong> In this randomized controlled trial, 34 eligible participants with self-reported lower limb pain and limited ambulation were randomized either to the intermittent pneumatic compression intervention group (IPCIG) or static compression control group (SCCG). The IPCIG and SCCG were trained to receive IPC and SC respectively for both lower legs and instructed to continue the application independently at home for 15 minutes per session, 2 sessions a day, 7 days per week for 4 weeks independently at the home. Outcome measures of lower leg pain, AROM, walking capacity, and functional mobility were assessed at baseline and at the first, second, third, and fourth weeks after randomization. Quality of life was assessed at baseline and immediately after the intervention. <strong>Results and Discussion:</strong> IPCIG showed a more significant improvement compared to the SCCG at the post-interventional stage for QOL and all the subscales. The findings show that “80% improved QOL” is 53% higher with the application of IPC than with SC for 4 weeks. The IPCIG showed a more significant improvement in the 6-minute walk test (6 MWT) at the third and fourth weeks compared to the SCCG. A pairwise comparison of mean values of 6 MWT over 4 weeks within the IPCIG showed a significant difference between all the weeks. Pairwise comparisons between groups at each time point showed that the IPCIG showed a more significant improvement in the timed up and go (TUG) test at the third and fourth weeks compared to the SCCG. Pairwise comparison of mean values of TUG test within the IPCIG showed a significant difference over 4 weeks, except between the second and third weeks, fourth week, and third and fourth weeks. The IPCIG showed a more significant improvement in lower leg pain between all weeks except the first week compared to the SCCG. Pairwise comparison of mean values of lower leg pain over 4 weeks within the IPCIG showed a significant difference among all weekly outcomes except between 1 and 2 weeks. The IPCIG showed a more significant improvement in left and right ankle dorsiflexion ROM at the third and fourth weeks compared to the SCCG. <strong>Conclusions:</strong> The IPC was effective in reducing lower leg pain and increasing the AROM and improving the walking capacity, functional mobility level, and QOL of community-dwelling older people with walking disabilities. Walking disability in old age is a common condition requiring physical therapy. Intermittent pneumatic compression can be used as a physical therapy modality for this patient group.展开更多
Introduction: The benefit of intermittent pneumatic compression (IPC) for the prevention of venous thromboembolism and lymphedema has been well established in the literature. Recent evidence suggests that IPC plays a ...Introduction: The benefit of intermittent pneumatic compression (IPC) for the prevention of venous thromboembolism and lymphedema has been well established in the literature. Recent evidence suggests that IPC plays a beneficial role in circulation, hemodynamic peripheral pump, intravascular coagulation and arterial skin perfusion. Despite such evidence, the use of IPC in the treatment of resistant and chronic venous leg ulcers, has received little attention in practice. Case Presentation: We would like to report the case of successfully treated chronic and bilateral venous leg ulcer in an obese patient with IPC application and a review of the literature. Results: The use of IPC as an adjuvant therapy to the traditional multilayered compression therapy permitted significant resolution of the ulcers, reduced secondary infection incidence and prevented ulcer recurrence. Conclusion: In obese, minimally mobile patients with venous ulcers not responding to the traditional multilayered compression therapy application of IPC, an adjuvant therapy is recommended.展开更多
目的通过检索、评价并总结间歇性充气加压(intermittent pneumatic compression,IPC)用于成人重症患者下肢静脉血栓预防的相关文献,为临床工作改进提供依据。方法通过检索相关数据库如BMJ最佳临床实践、UpToDate临床决策支持系统、英国...目的通过检索、评价并总结间歇性充气加压(intermittent pneumatic compression,IPC)用于成人重症患者下肢静脉血栓预防的相关文献,为临床工作改进提供依据。方法通过检索相关数据库如BMJ最佳临床实践、UpToDate临床决策支持系统、英国国家卫生和临床技术优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰校际指南网络(Scottish Intercollegiate Guidelines Network,SIGN)、加拿大安大略注册护士协会网站(Registered Nurses′Association of Ontario,RNAO)、美国临床指南网(National Guideline Clearinghouse,NGC)、乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、Cochrane Library、PubMed和中国生物医学文献服务系统(Chinese Biomedical Literature Service System,SinoMed)、美国血液学会(American Society of Hematology,ASH)等。检索其中关于间歇性充气加压用于成人重症患者下肢静脉血栓防治方面相关的证据,包括临床决策、临床实践指南、证据总结、专家共识、系统评价等,对证据进行方法学质量评价,再按照主题提取与汇总证据资料。结果根据纳入标准共筛选出12篇文献,通过阅读、提取和汇总,整理了关于间歇性充气加压装置使用前评估患者、使用适应证、使用禁忌证、启动时机、实施前准备、充气方法、使用时长、停止时机、过程观察、并发症观察和文件记录11个主题的19条证据。结论通过证据总结,可帮助一线护理人员更高效地获取并理解和掌握证据,从而进一步规范IPC的临床使用,促进建立标准化IPC使用管理流程,提高IPC干预效果,防止患者的下肢静脉形成血栓,提高护理质量。展开更多
文摘<strong>Background and Purpose:</strong> Walking difficulties are defined as any reduction in speed, balance, or change of gait, causing limited ambulation. These difficulties are a common problem in older adults and may greatly affect their quality of life (QOL) and restrict their personal independence and participation. This study aimed to determine the effect of intermittent pneumatic compression (IPC) on lower leg pain, walking capacity, functional mobility, ankle range of motion (AROM), and QOL of community-dwelling older people with walking difficulties. <strong>Methods:</strong> In this randomized controlled trial, 34 eligible participants with self-reported lower limb pain and limited ambulation were randomized either to the intermittent pneumatic compression intervention group (IPCIG) or static compression control group (SCCG). The IPCIG and SCCG were trained to receive IPC and SC respectively for both lower legs and instructed to continue the application independently at home for 15 minutes per session, 2 sessions a day, 7 days per week for 4 weeks independently at the home. Outcome measures of lower leg pain, AROM, walking capacity, and functional mobility were assessed at baseline and at the first, second, third, and fourth weeks after randomization. Quality of life was assessed at baseline and immediately after the intervention. <strong>Results and Discussion:</strong> IPCIG showed a more significant improvement compared to the SCCG at the post-interventional stage for QOL and all the subscales. The findings show that “80% improved QOL” is 53% higher with the application of IPC than with SC for 4 weeks. The IPCIG showed a more significant improvement in the 6-minute walk test (6 MWT) at the third and fourth weeks compared to the SCCG. A pairwise comparison of mean values of 6 MWT over 4 weeks within the IPCIG showed a significant difference between all the weeks. Pairwise comparisons between groups at each time point showed that the IPCIG showed a more significant improvement in the timed up and go (TUG) test at the third and fourth weeks compared to the SCCG. Pairwise comparison of mean values of TUG test within the IPCIG showed a significant difference over 4 weeks, except between the second and third weeks, fourth week, and third and fourth weeks. The IPCIG showed a more significant improvement in lower leg pain between all weeks except the first week compared to the SCCG. Pairwise comparison of mean values of lower leg pain over 4 weeks within the IPCIG showed a significant difference among all weekly outcomes except between 1 and 2 weeks. The IPCIG showed a more significant improvement in left and right ankle dorsiflexion ROM at the third and fourth weeks compared to the SCCG. <strong>Conclusions:</strong> The IPC was effective in reducing lower leg pain and increasing the AROM and improving the walking capacity, functional mobility level, and QOL of community-dwelling older people with walking disabilities. Walking disability in old age is a common condition requiring physical therapy. Intermittent pneumatic compression can be used as a physical therapy modality for this patient group.
文摘Introduction: The benefit of intermittent pneumatic compression (IPC) for the prevention of venous thromboembolism and lymphedema has been well established in the literature. Recent evidence suggests that IPC plays a beneficial role in circulation, hemodynamic peripheral pump, intravascular coagulation and arterial skin perfusion. Despite such evidence, the use of IPC in the treatment of resistant and chronic venous leg ulcers, has received little attention in practice. Case Presentation: We would like to report the case of successfully treated chronic and bilateral venous leg ulcer in an obese patient with IPC application and a review of the literature. Results: The use of IPC as an adjuvant therapy to the traditional multilayered compression therapy permitted significant resolution of the ulcers, reduced secondary infection incidence and prevented ulcer recurrence. Conclusion: In obese, minimally mobile patients with venous ulcers not responding to the traditional multilayered compression therapy application of IPC, an adjuvant therapy is recommended.
文摘目的通过检索、评价并总结间歇性充气加压(intermittent pneumatic compression,IPC)用于成人重症患者下肢静脉血栓预防的相关文献,为临床工作改进提供依据。方法通过检索相关数据库如BMJ最佳临床实践、UpToDate临床决策支持系统、英国国家卫生和临床技术优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰校际指南网络(Scottish Intercollegiate Guidelines Network,SIGN)、加拿大安大略注册护士协会网站(Registered Nurses′Association of Ontario,RNAO)、美国临床指南网(National Guideline Clearinghouse,NGC)、乔安娜布里格斯研究所(Joanna Briggs Institute,JBI)循证卫生保健中心数据库、Cochrane Library、PubMed和中国生物医学文献服务系统(Chinese Biomedical Literature Service System,SinoMed)、美国血液学会(American Society of Hematology,ASH)等。检索其中关于间歇性充气加压用于成人重症患者下肢静脉血栓防治方面相关的证据,包括临床决策、临床实践指南、证据总结、专家共识、系统评价等,对证据进行方法学质量评价,再按照主题提取与汇总证据资料。结果根据纳入标准共筛选出12篇文献,通过阅读、提取和汇总,整理了关于间歇性充气加压装置使用前评估患者、使用适应证、使用禁忌证、启动时机、实施前准备、充气方法、使用时长、停止时机、过程观察、并发症观察和文件记录11个主题的19条证据。结论通过证据总结,可帮助一线护理人员更高效地获取并理解和掌握证据,从而进一步规范IPC的临床使用,促进建立标准化IPC使用管理流程,提高IPC干预效果,防止患者的下肢静脉形成血栓,提高护理质量。
