How does it work?

As previously described, Veinoplus is an electrotherapeutic device that increases venous return to the heart. It’s mechanism of action is via the administration of electrical impulses to the musculature around the calves, thus causing excitatory stimulation of motor neurons. The activation of these motor neurons causes muscle contraction and relaxation, promoting venous return. This is otherwise known as a skeletal muscle pump.

The skeletal muscle pump mechanism works on the theory that contraction and relaxation of the calf muscles will compress the intramuscular veins causing an upwards movement of blood towards the heart. This is due to the valvular nature of the veins, which only allows unidirectional blood flow.

http://www.vhlab.umn.edu/atlas/phystutorial/phystutorial2.shtml

Veinoplus is administered at:

• Modulated frequency from 1 to 250Hz (within the electrical stimulation range)
• Biphasic symmetrical waveform to ensure no accumulation of charge within the tissues (Instruction Manual)
• Variable number of daily sessions - ranging from 1 - 3/day and 20 minute sessions (Li Tohic, Bastian, Pujo, Beslot, Mollard & Madelenat, 2008; Bogachev, Golovanova, Kuznetsov, Shekoyan & Bogacheva, 2011).
• Electrode placement is bilateral, with one electrode on each calf muscle simultaneously. This may appear conflicting to other set-ups of electrical stimulation where electrodes placed bilaterally is advised against, due to the current potentially flowing through the heart. In Veinoplus' case, it is clinically proven to be safe and effective using this electrode placement, even in pregnant women, presumably due to the very low quantities of electrical energy produced (Instruction manual).

Personal experience with the Veinoplus device confirmed the ease of use for the general population and patients who will benefit. Application of the device involves electrode placement on both calves with self-ashesive electrodes which are easy to apply. It is then a matter of connecting the electrodes to the handheld machine, pressing on and increasing the intensity (+ button) until you feel a deep muscular pulsation. The sensation may differ between legs, therefore intensity should be adjusted based upon the more sensitive limb. It appeared that if the intensity was increased too much, a tingling sensation is felt into the toes. In this case, the intensity should be reduced to a comfortable level.

So who will benefit most from Veinoplus therapy?

Pregnant women

Research shows that pregnant women are at greater risk of developing venous pooling due to their hypercoagulative state.These women have a greater amount of coagulation factors and decreased fibrinolytic activity, thus decreasing their venous flow velocity in the lower limbs by up to 50% (Marik, P. 2010). Although this may appear abnormal or scary to pregnant woman, it has been stated that these vascular changes and the presence of lower limb odema are healthy and normal consequences of the increase in hydration, naturally occurring with pregnancy (Robertson, 1971). As pregnant women are unable to exercise as regularly as their non-pregnant counterparts, the use of Veinoplus may be advantageous for initiating the skeletal muscle pump mechanism, preventing thrombus formation within the slow moving blood by increasing flow velocity. (http://www.thebabycorner.com/page/2562/)

Obesity

Individuals who are obese have been shown to have decreased venous function. This is due to increased abdominal pressures measured in those with obesity forcing more blood into the lower extremities and making it more difficult for blood to overcome the pressure gradient towards the heart. The weight of the abdomen and the mass of the visceral fat could also contribute to decreased venous function by impinging on the veins in the pelvis and groin (Rij, Alwis, Jiang, Christie, Hill, Dutton & Thomson, 2008).

Prolonged sitting or standing                                   

In these states, individuals are not activating their calf-muscle pumps thus slowing the velocity of the blood within the lower limbs. If the blood moves too slowly, it can cause improper closure of the valves leading to venous backflow and pooling. This greatly increases an individuals risk of developing a DVT. This is especially true in situations such as long-haul flights where individuals are more inactive and environmental factors such as reduced air pressure contribute to increased venous stress (Ball, K. 2003). http://www.copterplane.net/2012/aeroplane/

Hormone Therapy

Exogenous eostrogens may increase risk of venous thromboembolism (VTE) by altering the balance of coagulation factors and coagulation inhibition (Lowe, G. 2004). Thus, Veinoplus can ensure blood flow velocity is maintained so that VTE’s are less likely to form.

 References

1.  Ball, K. (2003) Deep Vein Thrombosis and Airline Travel—The Deadly Duo, AORN Journal. 77(2). 346-354. http://search.proquest.com.libraryproxy.griffith.edu.au/docview/200833315


2. Bogachev, V.Y., Golovanova, O.V., Kuznetsov, A.N., Shekoyan, A.O. & Bogacheva, N.V. (2011). Electromuscular stimulation with VEINOPLUS for the treatment of chronic venous edema. International Angiology, 30(6), 567-570.

3. Li Tohic, A., Bastian, H., Pujo, M., Beslot, P., Mollard, R. & Madelenat, P. (2009). Effects of electrostimulation (Veinoplus) on lower limbs venous insufficiency-related symptoms during pregnancy: Preliminary study. Gynecol Obstet Fertil, 37(1),18-24.

4. Lowe, G. (2004) Hormone Replacement Therapy and Cardiovascular disease: Increased Risks of Venous Thromboembolism and Stroke, and No Protection from Coronary Heart Disease, Journal of Internal Medicine, 256(5), 361-374, doi: 10.1111/j.1365-2796.2004.01400

5. Marik, P. (2010) Venous Thromboembolism in Pregnancy, Clinics in Chest Medicine, 31(4), 731-740, doi:10.1016/j.ccm.2010.06.004


6.  Rij, A. & Alwis, C. & Jiang, P. & Christie, R. & Hill, G. & Dutton, S. & Thomson, I. (2008) Obesity and Impaired Venous Function, European Journal Of Vascular and Endovascular Surgery, 35(6), 739-744, doi:10.1016/j.ejvs.2008.01.006

7. Robertson, E.G. (1971). The natural history of oedema during pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology, 78, 520–529. doi: 10.1111/j.1471-0528.1971.tb00310.x