Influences of postural alterations on the hemodynamic of the gait in patients with saphenous incompetence. A preliminary study

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COD: 06_2019_11_3093 Categorie: ,

Marco Bernardini, Gennaro Quarto, Dalila Del Sole, Eugenio Bernardini

Ann. Ital. Chir., 2019 90, 6

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OBJECTIVES: The aim of this study is to verify whether the postural alterations can influence the development of the varicose disease with unilateral and bilateral saphenous incompetence.
MATERIALS AND METHODS: 39 patients suffering from saphenous incompetence diagnosed by hemodynamic study with eco-color doppler (20 patients with bilateral venous insufficiency (VI), 19 patients with unilateral VI) have performed the gait analysis though wireless inertial sensor and baropodometry to assess the plantar pressure distribution both statically and dynamically.
RESULTS: The 68% and the 60% of subjects suffering from unilateral or bilateral VI present a plantar pressure dysfunction a single foot or both feet in static and/or in dynamic. In 63% of subjects with unilateral VI the propulsion is reduced on the lower limb damaged. The number of asymmetries in walking and dysfunctions in planar pressure in both groups has been calculated. The average number of asymmetries in walking in the group of patients with unilateral VI is significantly greater (p-value=0.0075) compared to the group of patients with bilateral VI.
CONCLUSIONS: Plantar pressure and increased valvo-muscular pump pressure (VMPP) are not the main etiological factors that modify the hemodynamic in walking. In unilateral cases the postural alterations may contribute to worsening or to appearance of the varicose veins. Postural disorders treatment in children of phlebopaths during the childhood could maintain the mild condition of varicose disease silent. The treatment in adults suffering from unilateral VI may reduce or prevent the appearance of relapses