THE EFFECT OF EXERCISE AND BODY POSITION ON THE VENOUS PRESSURE AT THE ANKLE IN PATIENTS HAVING VENOUS VALVULAR DEFECTS 1

Abstract

Venous pressure in the greater saphenous vein at the ankle was studied in 13 patients with varicose veins while resting in the recumbent, seated and standing positions and while walking on a treadmill. Confirmatory data were obtained indicating that the venous pressure at the ankle in the resting, sitting or standing positions in normal subjects and patients with incompetency of the saphenous veins is sufficient to support a column of blood to approx. the level of the 3d thoracic interspace. Walking on a level treadmill at 1.7 miles per hr. produced an avg. decrease in mean venous pressure at the ankle of 37 (30-47) mm. of mercury in 7 patients with primary varicose veins and 11 (5-13) mm. of mercury in 6 patients with varicose veins associated with a history of a previous ilio-femoral thrombophlebitis. In normal subjects this value was 64 (54-71)mm. of mercury. In patients who had uncomplicated incompetency of the greater saphenous vein the avg. time required for the venous pressure to return to the resting standing level after cessation of walking was 2.8 (1.2-5.5) sec. In those patients with a history of previous iliofemoral thrombophlebitis the pressure rose to levels slightly in excess of the control resting value within 1 sec. after completion of the walk as contrasted to the 31 (8-57) sec. required for the pressure to return to the control values after walking in normal subjects. These data are in harmony with the concept that the function of the venous valves in conjunction with the action of voluntary muscles is of primary importance in the regulation of venous pressure at the ankle.