Low-pressure sequential compression of lower limbs enhances forearm skin blood flow

Abstract

Purpose: We investigated whether forearm skin blood flow could be improved when a multilayer pulsatile inflatable suit was applied at a low pressure to the lower limbs and abdomen. We hypothesized that a non-invasive purely mechanical stimulation of the lower limbs could induce remote forearm blood flow modifications. Methods: The pulsatile suit induced a sequential compartmentalized low compression (65 mmHg), which was synchronized with each diastole of the cardiac cycle with each phase evolving centripetally (lower limbs to abdomen). Modifications of the forearm skin blood flow were continuously recorded by laser Doppler flowmetry (LDF) at baseline and during the pulsatile suit application. Endothelium-dependent and endothelium-independent vasodilations of the forearm skin microcirculation were measured by LDF in response to a local transdermal iontophoretic application of acetylcholine (ACh-test) and to hyperthermia (hyperT- test). Results: Twenty-four healthy volunteers, 12 men and 12 women (43±14 years) were included in the study. LDF responses increased 1) under pulsatile suit (97±106%, p < 0.01), 2) during ACh-test (338±336%, p < 0.001) and 3) during hyperT-test (587±383%, p < 0.001). No significant gender differences were seen. There was a significant linear positive regression between LDF response under pulsatile suit and during ACh-test (R= 0.79, p < 0.001) and during hyperT-test (R=0.62, p=0.004). No adverse effects were reported. Conclusions: This proof-of-concept study shows that a sequential low-pressure compression applied to the lower limbs and abdomen induces a significant increase of the forearm skin blood flow, suggestive a systemic effect. Mechanisms still need to be investigated.