Comparison of intermittent pneumatic compression and neuromuscular electrical stimulation using ultrasound and laser doppler fluximetry

INTRODUCTION - Enhancement of peripheral circulation has demonstrated benefit in many vascular disorders. This study compares the haemodynamic efficacy of a novel neuromuscular electrical stimulation (NMES) device with IPC in healthy subjects.

METHODS – 10 healthy volunteers were randomised into two groups. Baseline measurements of superficial femoral arterial and venous velocity and flow were taken. Subjects received bilateral therapy with both devices in turn - SCD Express (Kendall) and geko-T1 (Firstkind UK), the order reversed between groups. Laser doppler fluximetry readings were taken from hand and foot. Baseline readings were compared with readings after immediate cessation, and after 10 minutes.

RESULTS –6 males and 4 females, mean age 27.1, BMI 24.8 completed the study. IPC caused 51% (p=0.002), 5% (ns) and 3% (ns) median changes in venous peak velocity, TAMV and flow rate respectively; NMES stimulation caused a 103%, 101% and 101% median changes in the same parameters (all p=0.002). The benefit was lost upon deactivation. IPC did not improve arterial haemodynamics. NMES caused 11%, 84% and 75% increase in arterial parameters (p<0.01). Laser doppler readings taken from the leg were increased by NMES (P<0.001), dropping after deactivation. For IPC, the readings decreased during use but increased after cessation. Hand flux signal dropped during activation of both devices, rising after cessation.

DISCUSSION – The NMES device enhances venous flow and peak velocity in the legs of healthy subjects, warranting further clinical evaluation. It enhances arterial TAMV and flow rate, which may prove to be of clinical use in the management of peripheral arterial disease.