Clinical Improvement of Skin Microcirculation in Patients with Chronic Venous Incompetence (CVI) by Physical Exercise Training

Abstract

Objective: The comparative determination of cutaneous microcirculation in patients with CVI in Widmer stages I-III by measuring tcpO2 and laser Doppler flux during a 26 week vascular sports programme. Patients: Thirty-two patients (12 women and 20 men) with an average age of 57 (plus or minus) 9 years took part in a half-year study, completing a one-hour exercise therapy session twice a week. The control group was composed of 11 individuals in the same age range but with healthy veins. Methods: The patients were examined at the beginning of the study and again after 26 weeks. Measurements performed on the symptomatic leg included ulcer size, Laser Doppler flux using a HeNe laser (Model PF2 b Periflux, Perimed, Stockholm, Sweden) and tcpO2 with the TCM2 oxygen monitor (Radiometer, Copenhagen). Results: In the 10 CVI patients with prominent leg ulcers, there was a significant reduction in ulcer size during exercise therapy from 817 mm2 to 121 mm2 after 26 weeks. Patients in stage II already had a reduced oxygen partial pressure of 40 mmHg, while stage III patients had pathologically low resting values of 4 mmHg. These values rose in the course of vascular sports therapy to 50 mmHg (+ 10 mmHg) in CVI stage II patients and 21 mmHg (+ 17 mmHg) in stage III patients. The average resting tcpO2 value of all 32 CVI patients rose during therapy from 36 mmHg to 41 mmHg. Conclusion: All of the CVI patients, especially those in stage III, profited from sports therapy. This was documented in a significant increase in tcpO2 as well as a reduction of inflammatory hyperperfusion. The improved flux/oxygenation ratio, indicating improved cutaneous nutrition, was manifest by a highly significant reduction in venous ulceration. There was neither clinical deterioration or complications during therapy.