Key result
Early ambulation with compression stockings in acute DVT significantly improved leg circumference reduction at 7 days compared to bed rest (P<0.05), with no difference in pulmonary embolism risk.
Why the study?
Does early ambulation with compression stockings improve symptom resolution without increasing pulmonary embolism risk in patients with acute deep venous thrombosis compared to bed rest?
RCT (n=40)
arbitrarily randomized
Does early ambulation with compression stockings improve symptom resolution without increasing pulmonary embolism risk in patients with acute deep venous thrombosis compared to bed rest?
p-value: p=< 0.05
Early ambulation with compression stockings in acute DVT safely accelerates the resolution of pain and swelling without increasing the risk of pulmonary embolism compared to traditional bed rest.
Supports early ambulation with compression over bed rest in acute DVT; extends RCT evidence for faster symptom relief without added PE risk.
Objective To evaluate the benefits and the risk of pulmonary embolism between walking exercises and bed rest in the acute stage of deep venous thrombosis (DVT). Methods From February 2008 to March 2009,40 acute primary DVT patients were arbitrarily randomized into controlled group and experimental group,with 20 cases in each group,who were hospitalized within seven days of onset.Patients in controlled group underwent bed rest for 7-10 days,wearing elastic stockings.While patients in experimental group were early (1-2 days after admission) off bed walking about 600-1200 m every day with elastic stockings for 7-10 days.During the process patients in both group received regular anticoagulation treatment,and continued warfarin anticoagulation therapy after out of hospital for at least 6 months.The clinical characteristics of the two groups were comparable.Primary end points were the reduction of pain assessed daily with the Visual Analogue Scale (VAS),the reduction of leg circumference at thigh,and cumulative pulmonary embolism incidences of two groups in three months. Results Symptoms in all patients of the two groups were improved,but the pain level showed a statistically significant reduction starting after the third day(58 ±8) mm in the experiment group and after the fifth day (58 ± 13) mm in the controlled group.The leg circumferences of the two groups after 7 days were statistically significantly different (P ＜ 0.05),the cumulative pulmonary embolism incidences of the two groups for 3 months were not statistically significantly different. Conclusion Mobile patients with acute DVT should be encouraged to walk with medical compression stockings.The rate of resolution of pain and swelling is significantly faster when the patient ambulates with compression.The quality of life significantly improved.The risk of pulmonary embolism does not significantly increase by this approach.
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Huang et al. (2010) conducted an RCT in acute deep venous thrombosis (n=40). Early ambulation with elastic stockings vs. Bed rest with elastic stockings was evaluated on Reduction of pain (VAS), reduction of leg circumference at thigh, and cumulative pulmonary embolism incidences in 3 months (p=< 0.05). Early ambulation with compression stockings in acute DVT significantly improved leg circumference reduction at 7 days compared to bed rest (P<0.05), with no difference in pulmonary embolism risk.
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