2. How It Works Mechanical pressure produced by the intermittent compression forces fluids within the venous system back towards the heart.
3. How It Works Intermittent compression reduces the pressure gradient between the tissue hydrostatic pressure and the capillary filtration pressure (see cap. filt. pressure powerpointto learn more), which encourages the reabsorption of interstitial fluids.
4. How It Works A second pressure gradient is created between the distal portion (high pressure) and the proximal portion (low pressure) of the extremity, resulting in fluid movement.
5. How It Works Spreading the edema proximally over a larger area allows more lymphatic ducts to absorb the solid matter within the edema.
6. How It Works When treating lower leg edema with a pressure of 35-55 mm Hg, venous flow velocity increases 175 percent. When using pressures between 90 and 100 mm Hg, venous flow accelerates 336 percent!
7. IC Types There are two basic types of intermittent compression units, circumferential and sequential. Both can significantly reduce edema in an injured extremity.
8. IC Types Circumferential units apply an equal amount of pressure to all parts of the treated extremity at the same time.
9. IC Types Sequential units have pressure chambers within the sleeve (called a garment) placed around the extremity, and these chambers fill sequentially from distal to proximal. For example, the most distal chamber fills first, then the next compartment and so on. This results in a distal to proximal pressure gradient.
11. Application The pressure used should not exceed the patient’s diastolic blood pressure. Maximum pressure ranges used for treating the upper extremity are 40-60 mm Hg; 60-100 for the lower extremity.
13. Application For sanitary precautions, cover the area to be treated with stockinette. Make sure there are no wrinkles as this can cause high pressure areas and subsequent bruising.
14. Application For sanitary precautions, cover the area to be treated with stockinette. Make sure there are no wrinkles as this can cause high pressure areas and subsequent bruising.
15. Application Starkey recommends a 3:1 on/off time cycle (45 seconds on, 15 seconds off) for a 20-30 minute treatment time (Denegar recommends 30-40 seconds on, 20-30 seconds off).
16. Application Starkey recommends a 3:1 on/off time cycle (45 seconds on, 15 seconds off) for a 20-30 minute treatment time (Denegar recommends 30-40 seconds on, 20-30 seconds off).
17. Application Encourage the patient to perform gentle ROM exercises (wiggle fingers or toes) during the off time. Instruct the patient to notify you if pain or a “tingling” feeling occurs.
18. Application Encourage the patient to perform gentle ROM exercises (wiggle fingers or toes) during the off time. Instruct the patient to notify you if pain or a “tingling” feeling occurs.
19. Contraindications Contraindications include but are not limited to: Deep Vein Thrombosis Compartment syndromes Venous and other vascular insufficiencies Fracture Pulmonary edema Congestive hear failure and other circulatory diseases (ie: arteriosclerosis)
20. References Denegar et al, Therapeutic Modalities for Musculoskeletal Injuries, 3rd edition Knight and Draper, Therapeutic Modalities: The Art and Science Starkey, Therapeutic Modalities, 3rd edition
