COMPRESSION THERAPY

INTRODUCTION:

Compression Therapy is a mechanical force that increases external pressure on the body or body part.

Types:
1.Static Compression
2.Intermittent Compression

Uses of Compression

Improve fluid balance (by increasing hydrostatic pressure in the interstitial space)
Improve circulation
To modify scar tissue formation.
Clinical Application

Compression is used for

Control of peripheral edema
Prevention of DVT
Residual limb shaping
Healing of venous ulcers

Effects of Compression

Improve Venous and lymphatic Circulation
Limit the shape and size of tissue
Increases tissue temperature

Venous and lymphatic Circulation.

Both static and intermittent compression devices can be used but intermittent compression is more effective than static.
It can cause a wave of vessel constriction moving in a proximal direction.
Improving circulation can benefit patients with edema & DVT(Deep vein thrombosis).
Shape and size of Tissue.
Static compression garments can limit the shape and size of new tissue formation.
This type of compression device acts as a second skin, which, having less elasticity than skin thus limit the shape and size of tissue.

The compression garments can be used over:

a.Residual limb after amputation
b.Burn damaged skin
c.Edematous limb

Tissue Temperature
Compression devices increase superficial tissue temperature by insulating the area to which it is applied.
It is proposed that warmth produce by compression garments increases the activity of temperature sensitive enzyme which breakdown collagen such as collagenase.

Clinical indications
1.Edema
2.Prevention of deep vein thrombosis
3.Venous stasis ulcers
4.Residual limb shaping after amputation
5.Control of hypertrophic scarring

Edema

Causes:

Venous or lymphatic obstruction
Increased capillary permeability
Increase plasma volume
Exercise
Trauma
Surgery
Burn

Pathology:

Normal fluid equilibrium is maintained by balance between hydrostatic and osmotic pressure inside and outside the blood vessels.
When there is disturbance in this normal mechanism edema occurs.
A healthy diet, vascular system and muscular contraction act together to ensure that appropriate amount of fluid exits in veins and flow back to heart.
Dysfunction in any of these mechanisms can result in increased movement of fluid from the vessels into the extra vascular fluid.
Edema caused by venous insufficiency
The peripheral veins function is to carry deoxygenated blood from the periphery back to heart.
When the calf muscles contract they exert a pressure of 200 mmHg on veins and pushes the fluid proximally.
After contraction, pressure on veins falls allowing veins to refill.

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Venous insufficiency can be the result of:

Lack of physical activity
Dysfunction of venous valves
Mechanical obstruction of the veins by tumor
Phlebitis

Lymphedema

Lymphatic system consist of large network of vessels and nodes through which lymph flows and drain into circulatory system for elimination.
By any mechanism/cause if there is disturbance in this normal mechanism, lymphedema occurs.
Etiology:
Decreased level of plasma protein
Mechanical obstruction of lymphatics
Abnormal distribution of lymphatic vessels or lymph nodes

If the plasma protein level drops below 3.3 gm/dL, lymphedema likely to occur.

pic

Types of lymphedema:
i.Primary lymphedema
ii.Secondary lymphedema

Adverse effects of edema

Impaired ROM
Limitation of function
Pain
Induration of skin
Increase risk of infection
Cellulitis
Ulceration
Amputation
Dermatitis
Brown skin pigmentation

pic

Principles of compression therapy:

Compression controls edema by increasing extravascular hydrostatic pressure and by promoting circulation.
The hydrostatic pressure in the interstitial space becomes greater reducing the outflow of fluid from the vessels.

Prevention of DVT:

Comments

முதுகு வலி மற்றும் முதுகு தண்டுவட வலி உள்ளவர்களுக்கு கடைபிடிக்க வேண்டிய சில வழிமுறைகள்....

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