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August 10, 2019Experimental Physiology10 citationsOpen Access

The passive leg movement technique for assessing vascular function: defining the distribution of blood flow and the impact of occluding the lower leg

KSKatherine L. ShieldsRBRyan M. BroxtermanCJCatherine L. Jarrett

Key Result

Cuff occlusion of the lower leg during passive leg movement significantly attenuated the peak change in blood flow in the superficial femoral artery (324 to 214 ml/min) and common femoral artery.

Structured PICO

Does cuff-induced blood flow occlusion to the lower leg alter the hyperaemic response to passive leg movement in healthy subjects?

P
Population
10 healthy subjects who underwent passive leg movement with and without cuff-induced blood flow occlusion to the lower leg.
I
Intervention
Passive leg movement (PLM) with cuff-induced blood flow occlusion to the lower leg
C
Comparator
Passive leg movement (PLM) without cuff-induced blood flow occlusion
O
Outcome
Blood flow distribution and peak change in blood flow (BF Δpeak) in the common (CFA), deep (DFA), and superficial (SFA) femoral arteries assessed by Doppler ultrasoundsurrogate

Cuffing the lower leg during passive leg movement attenuates blood flow through the superficial femoral artery and should be considered to emphasize thigh-specific hyperaemia in vascular function assessments.

Main Result

Absolute Event Rate: 214% vs 324%

Abstract

New Findings What is the central question of this study? What is the distribution of the hyperaemic response to passive leg movement (PLM) in the common (CFA), deep (DFA) and superficial (SFA) femoral arteries? What is the impact of lower leg cuff‐induced blood flow occlusion on this response? What is the main finding and its importance? Of the total blood that passed through the CFA, the majority was directed to the DFA and this was unaffected by cuffing. As a small fraction does pass through the SFA to the lower leg, cuffing during PLM should be considered to emphasize the thigh‐specific hyperaemia. Abstract It has yet to be quantified how passive leg movement (PLM)‐induced hyperaemia, an index of vascular function, is distributed beyond the common femoral artery (CFA), into the deep femoral (DFA) and the superficial femoral (SFA) arteries, which supply blood to the thigh and lower leg, respectively. Furthermore, the impact of cuffing the lower leg, a common practice, especially with drug infusions during PLM, on the hyperaemic response is, also, unknown. Therefore, PLM was performed with and without cuff‐induced blood flow (BF) occlusion to the lower leg in 10 healthy subjects, with BF assessed by Doppler ultrasound. In terms of BF distribution during PLM, of the 380 ± 191 ml of blood that passed through the CFA, 69 ± 8% was directed to the DFA, while only 31 ± 8% passed through the SFA. Cuff occlusion of the lower leg significantly attenuated the PLM‐induced hyperaemia through the SFA (∼30%), which was reflected by a fall in BF through the CFA (∼20%), but not through the DFA. Additionally, cuff occlusion significantly attenuated the PLM‐induced peak change in BF (BF Δpeak ) in the SFA (324 ± 159 to 214 ± 114 ml min −1 ), which was, again, reflected in the CFA (1019 ± 438 to 833 ± 476 ml min −1 ), but not in the DFA. Thus, the PLM‐induced hyperaemia predominantly passes through the DFA and this was unaltered by cuffing. However, as a small fraction of the PLM‐induced hyperaemia does pass through the SFA to the lower leg, cuffing the lower leg during PLM should be considered to emphasize thigh‐specific hyperaemia in the PLM assessment of vascular function.

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Cite This Study

Shields et al. (2019) studied Healthy (n=10). Cuff-induced blood flow occlusion to the lower leg vs. Without cuff-induced blood flow occlusion was evaluated on PLM-induced peak change in blood flow in the superficial femoral artery. Cuff occlusion of the lower leg during passive leg movement significantly attenuated the peak change in blood flow in the superficial femoral artery (324 to 214 ml/min) and common femoral artery.

synapsesocial.com/papers/6a6c49aa3e46b6df0af3556chttps://doi.org/10.1113/ep087845
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