Veinoplus e-stim therapy is only one therapy targeted at preventing and treating venous disease by improving venous return, reducing venous reflux and peripheral oedema. The main alternative conservative therapy which could be indicated as well as, or instead of, is simply exercise, including avoiding prolonged sitting or standing.
Exercise and the associated skeletal muscle activity increases venous return (Laughlin, 1999), as does Veinoplus therapy in patients with limited or moderate vascular insufficiency. Exercise however, presents with many additional health benefits which clearly indicates it is an appropriate alternative or superior treatment for the same populations Veinoplus is marketed to. Those individuals being those with no contraindications, such as advanced CVD or musculoskeletal injury.
Additional health benefits which are associated with exercise, but not Veinoplus therapy include:
- Decreased hypertension,
- Improved glucose metabolism & insulin sensitivity
- Important factor in weight loss
- Improved blood lipid levels
- Decreased thrombosis formation (increased fibrinolytic ability)
- Improved endothelial function
- Improved autonomic nervous system function (Shepard et al, 1999).
As previously mentioned, exercise is supported by literature in general (Boccalon, 1999) as an effective and viable option, for assisting to prevent venous disease or similar symptoms associated with impaired venous return, all of which are indications in each of Veinoplus's target populations.
Exercise in pregnant populations has been recommended for those without pregnancy complications to provide all the same benefits as in general populations, as well as numerous additional benefits targeted at common pregnancy consequences, including reduction of leg oedema (Duckitt, 2011). An article by Debert (2011) also included prevention of blood clots (VTEs) and varicose veins as benefits of exercising during pregnancy. A common benefit was mentioned in the previous post regarding the use of Veinoplus in pregnancy for VTE prevention.
As with pregnancy, exercise is clearly important and indicated for obese populations due to the numerous health benefits including the support of weight loss (Okay, Jackson, Marcinkiewicz & Papino, 2009). Because obesity is a recognised risk factor for decreased venous function, by promoting weight loss and exercise, it assists in the prevention and treatment of venous disease. This additional weight loss effect that comes with exercise is arguably a great selling point for exercise over Veinoplus in the prevention and treatment of venous disease.
Veinoplus and exercise both represent therapies which are more preventative of venous diseases and treatment for venous symptoms such as leg oedema or the increased risk of VTEs associated with pregnancy. As mentioned in the second paragraph of this post, these are beneficial treatments for limited to moderate conditions. In the case of moderate to severe venous conditions and associated VTEs, an example of which is displayed in the above image where the patient has stasis pigmentation due to severe venous insufficiency, the treatment is more focused towards drug therapy with anticoagulant, venous surgery and endoluminal venous abalaton, depending on the specific pathology (McLafferty, 2006).
An important venous disease preventative and treatment therapy not yet discussed, or compared to Veinoplus, is compression therapy which is achieved by applying graduated compression stockings (GCS) to the at risk patient. This external compression of the legs replaces the compression caused by skeletal muscle with Veinoplus or exercise therapies and results in:
- Preventing venous stasis (promoting venous blood flow velocity)
- Preventing vessel injury
- Preventing coagulation (Joanne Briggs Institute, 2001).
A study by Zajkowski et al (2002) found that in patients with venous insufficiency, GCSs were more effective at preventing venous reflux than improving skeletal muscle pump action; however this is still a positive indication for use. A literature review by Xo (2010) concluded that the use of GCSs were indicated in those patients with increased risk factors for deep vein thrombosis and to combat dependant oedema but also that their use was fraught with many contraindications including peripheral skin conditions and critical limb ischemia and thus must be prescribed and applied with caution.
In summary there are a number of alternative therapies to Veinoplus which produce the same results, leaving us with the question is Veinoplus, at $350 unit, a practical and realistically competitive option for prevention of leg oedema and venous disease?
References
1. Boccalon, H. (1999). Venous disease. International Angiology, 18(1), 15-16
2. Debert, C. (2011). Exercising during pregnancy. Family Health, 27(1), 22-23
3. Duckitt, K. (2011). Exercise during pregnancy. British Medical Journal, 343, d5710
4. Joanna Briggs Institute. (2006). Graduated compression stockings: prevention of postoperative venous thromboembolism is crucial. American Journal of Nursing, 106(2), 72AA- 72DD
5. McLafferty, R.B. (2006). Office-based treatment of venous disease. Perspectives in Vascular Surgery and Endovascular Therapy, 18(4), 306-310, DOI: 10.1177/1531003506297364
6. Okay, D.M., Jackson, P.V., Marcinkiewicz, M., & Papino, M.N. (2009). Exercise and obesity. Primary Care: Clinics in Office Practice, 36, 379-393, DOI: 10.1016/j.pop.2009.01.008
7. Shepherd, R.J., & Balady, G.J. (1999). Exercise as cardiovascular therapy. Journal of the American Heart Association: Circulation, 99(7), 963-972, DOI: 10.1161/01.CIR.99.7.963
8. Xu, B. (2010). DVT in acute stroke - the use of graduated compression stockings. Australian Family Physician, 39(7), 485-487
9. Zajkowski, P.J., Proctor, M.C., Wakefield, T.W., Bloom, J., Blessing, B., & Greenfield, L.J. (2002). Compression stockings and venous function. Archives of Surgery, 137(9), 1064-1068
I appreciate the additional research you have done to appropriately cover the alternatives to Veinoplus applications, S, K & J. I can see the relevance of that image of grossly swollen legs - but a reference to it from the text would clarify - is that extreme obesity (my guess) or some sort of lymphoedema? You may have a go at answering your own questions in the final post. i.e. I reckon the long-haul flights niche is a valid one. You may conclude that more comparative work has to be done before the answers become clear - CY
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