The changes in intramuscular pressure and femoral vein flow with continuous passive motion, pneumatic compressive stockings, and leg manipulations

: Intramuscular pressure was measured continuously in the deep compartment of the calf and anterior thigh of volunteers while their legs were cyclically moved from 0 degrees to 90 degrees back to 0 degrees (angle of knee flexion) in an anatomic continuous passive motion (CPM) device and a nonanatomic CPM device. Femoral venous flow was measured continuously using a thermodilution technique in volunteers while their legs were moved in both CPM devices, during inflation of a pneumatic stocking, and during several leg manipulations. Baseline intramuscular pressures in the deep calf and anterior thigh were 10.0 +/- 1.9 mmHg and 4.9 +/- 1.9 mmHg, respectively (mean +/- standard error). Both the anatomic and nonanatomic CPM devices produced a statistically significant maximal increase in pressure in the calf. By contrast, only a decrease in pressure occurred in the thigh with both devices. Baseline femoral vein flow measured by the thermodilution technique was 311 +/- 38 ml per minute. Significant increases in femoral vein flow were seen with both CPM devices. The maximal flow produced by the anatomic CPM was 1199 ml per minute and was approximately four times higher than baseline flow and approximately 1.4 times the maximal flow change seen with the nonanatomic CPM (836 ml per minute). The greatest net increase in flow was observed between 60 degrees and 90 degrees of knee flexion with both devices. Overall, passive straight-leg elevation produced the largest flow (1524 ml per minute), followed by the anatomic CPM and nonanatomic CPM, and then by active ankle dorsiflexion(640 ml per minute), pneumatic stocking inflation (586 ml per minute), manual calf compression (532 ml per minute), and passive dorsiflexion (385 ml per minute)(ABSTRACT TRUNCATED AT 250 WORDS)