Application of deep oscillation therapy in the treatment of peripheral arterial diseases

R.  Trybulski; G.  Biolik; W.  Kuczmik; N.  Ivasyk; O.  Tyravska

doi:10.26641/2307-0404.2023.3.289207

Authors

R. Trybulski Upper Silesian Academy, Department of Physiotherapy Scouts, September str., 1939/3, Katowice, 40-659, Poland https://orcid.org/0000-0002-4276-4813
G. Biolik Medical University of Silesia, Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Ziołowa str., 45/47, Katowice, 40-635, Poland https://orcid.org/0000-0001-8223-9370
W. Kuczmik Medical University of Silesia, Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Ziołowa str., 45/47, Katowice, 40-635, Poland https://orcid.org/0000-0002-0927-0977
N. Ivasyk Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnologies of Lviv, Pekarska str., 50, Lviv, 79010, Ukraine https://orcid.org/0000-0002-0053-2854
O. Tyravska Ivan Bobersky Lviv State University of Physical Culture, Kostiushka str., 11, Lviv, 79000, Ukraine https://orcid.org/0000-0002-4555-7756

DOI:

https://doi.org/10.26641/2307-0404.2023.3.289207

Keywords:

physical medicine, microcirculation, intermittent claudication, physical training, vascular disease

Abstract

Intermittent claudication is a common symptom of peripheral arterial disease, affecting up to 50% of patients over the age of 50, which is characterized by pain, discomfort, and cramping in the leg muscles during physical activity. Intermittent claudication is a common symptom of lower extremity arterial disease (LEAD), which significantly impacts patients’ quality of life and drives healthcare costs. Current treatments for intermittent claudication are often inadequate, leading to a need for more effective treatments. Developing new treatments is critical to improve outcomes for patients and address the public health implications of LEAD. This study’s aim was to present the impact of comprehensive physiotherapy, conducted independently, with the supervision of a physiotherapist, for 14 weeks, on a patient with intermittent claudication caused by peripheral arterial disease. The therapy included bicycle training in a form of physical therapy at home, combined with deep oscillation therapy. Deep oscillation therapy involved the use of an electrostatic field with a frequency of 5 to 250 Hz. The field was applied following the lymphatic drainage methodology. In the discussed case, a statistically significant and favourable increase in the measured variables was observed, such as the increase of bone-brachial index from 0.65 to 0.8, the increase of tissue perfusion, measured by laser Doppler flowmetry, from 12.3% to 61%, depending on the measurement site, and the increase in pain-free walking distance by 451%. TcPO₂ measurement in the affected leg increased from 31 to 48 mmHg. The use of physical therapy at home combined with deep oscillation showed improvements in pain-free walking distance, Ankle Brachial Index, and other measures in patients with peripheral arterial disease. Deep oscillation therapy demonstrated potential analgesic effects but also raised concerns about possible nerve damage. The study indicated that physical therapy at home might serve as an alternative to supervised exercise therapy, but it had limitations like a small sample size and lack of direct comparisons.

References

Jawień A, Filipiak KJ, Bręborowicz A, Mrozi-kiewicz-Rakowska B, Szymanski FM, Terlecki P, et al. Recommendations for the management of lower extremity artery disease (LEAD) based on ESVS/ /ESC 2017 guidelines. Position document of PTChN, PTNT, PTLR and SFSN PTK experts. Acta Angiologica. 2019;25:219-69. doi: https://doi.org/10.5603/AA.2019.0015

Nowakowski P, Buszman P, Janas A, Kiesz S, Buszman P. Five-year outcomes after revascularization of superficial femoral artery occlusion using Ocelot catheter. Advances in Interventional Cardiology. 2019;15(4):472-6. doi: https://doi.org/10.5114/aic.2019.90222

Bielecka-Dabrowa A, Lewek J, Sakowicz A, Pa-duszyńska A, Dąbrowa M, Orszulak-Michalak D, et al. Effects of Implementing Personalized Health Education in Ambulatory Care on Cardiovascular Risk Factors, Compliance and Satisfaction with Treatment. Journal of Personalized Medicine. 2022;12(10):1583. doi: https://doi.org/10.3390/jpm12101583

Kotseva K, De Backer G, De Bacquer D, Rydén L, Hoes A, Grobbee D, et al. Primary prevention efforts are poorly developed in people at high cardiovascular risk: A report from the European Society of Cardiology Eurobservational Research Programme EUROASPIRE V survey in 16 European countries. European Journal of Preventive Cardiology. 2021;28(4):370-9. doi: https://doi.org/10.1177/2047487320908698

Kapusta J, Irzmański R. The Impact of Controlled Physical Training with Hydrotherapy on Changes in Swel¬ling and Claudication Distance in Patients with Athe¬rosclerotic Ischemia of the Lower Limbs. International Journal of Environmental Research and Public Health. 2022;19(23):15715. doi: https://doi.org/10.3390/ijerph192315715

Pogorzelska J, Zaglaniczny D, Zmyślna A, Kiebzak W. Observation of deep oscillation usage and its effectiveness on burn scars – a case report. Medical Studies. 2017;33(1):46-50. doi: https://doi.org/10.5114/ms.2017.66956

Opuchlik A, Biskup M, Włoch A, Lipińska-Stańczak M, Lipińska A. Methods of physiotherapeutic mana¬gement used in the treatment of secondary lymphoedema in the Holycross Cancer Centre in Kielce. Medical Studies. 2014;30(2):123-30. doi: https://doi.org/10.5114/ms.2014.43606

Belmonte R, Tejero M, Ferrer M, Muniesa JM, Duarte E, Cunillera O, et al. Efficacy of low-frequency low-intensity electrotherapy in the treatment of breast cancer-related lymphoedema: a cross-over randomized trial. Clinical Rehabilitation. 2012;26(7):607-18. doi: https://doi.org/10.1177/0269215511427414

Hammad TA, Smolderen KG, Spertus JA, Jones PG, Shishehbor MH. Associations of exercise ankle–brachial index, pain-free walking distance and maximum walking distance with the Peripheral Artery Questionnaire: Finding from the PORTRAIT PAD Registry. Vascular Medicine [Internet]. 2018Jul.11;24(1):32-40. Available from: http://journals.sagepub.com/doi/10.1177/1358863X18785026

Banerjee D, Kamuren J, Baird GL, Palmisciano A, Krishnan I, Whittenhall M, Klinger JR, Ventetuolo CE. The Modified Borg Dyspnea Scale does not predict hospitalization in pulmonary arterial hypertension. Pulmonary Circulation [Internet]. 2017Mar.1;7(2):384-90. Available from: https://onlinelibrary.wiley.com/doi/10.1177/2045893217695568

Vaidya A, Kleinegris M-C, Severens JL, Ramaekers BL, ten Cate-Hoek AJ, ten Cate H, Joore MA. Comparison of EQ-5D and SF-36 in untreated patients with symptoms of intermittent claudication. Journal of Comparative Effectiveness Research [Internet]. 2018Jun.1;7(6):535-48. Available from: https://becarispublishing.com/doi/10.2217/cer-2017-0029

Morris CJ, Zawieja DC, Moore JE. A multiscale sliding filament model of lymphatic muscle pumping. Biomechanics and Modelling in Mechanobiology. 2021;20(6):2179-202. doi: https://doi.org/10.1007/s10237-021-01501-0

Hur S, Kim J, Ratnam L, Itkin M. Lymphatic Intervention, the Frontline of Modern Lymphatic Medicine: Part I. History, Anatomy, Physiology, and Diagnostic Imaging of the Lymphatic System. Korean Journal of Radiology. 2023;24(2):95-108. doi: https://doi.org/10.3348/kjr.2022.0688

Ma KF, Kleiss SF, Schuurmann RCL, Nijboer TS, El Moumni M, Bokkers RPH, et al. Laser Doppler Flow-metry Combined with Spectroscopy to Determine Pe-ripheral Tissue Perfusion and Oxygen Saturation: A Pilot Study in Healthy Volunteers and Patients with Peripheral Arterial Disease. J Pers Med. 2022 May 24;12(6):853. doi: https://doi.org/10.3390/jpm12060853

Shiba S, Shiba A, Hatada A. Differences in Physical Activity between Patients with Peripheral Artery Disease and Healthy Subjects. Journal of Ageing Research. 2020;2020:5093528. doi: https://doi.org/10.1155/2020/5093528

McDermott MM, Dayanidhi S, Kosmac K, Saini S, Slysz J, Leeuwenburgh C, et al. Walking Exercise Therapy Effects on Lower Extremity Skeletal Muscle in Peripheral Artery Disease. Circ Res. 2021 Jun 11;128(12):1851-67. doi: https://doi.org/10.1161/CIRCRESAHA.121.318242

Аntoaneta B, Magdalena GZ. Deep oscillation – a modern additional physical modality for analgesia in patients with back pain. Praemedicus. 2013;29:85-90.

Szymczak M, Oszkinis G, Majchrzycki M. The Impact of Walking Exercises and Resistance Training upon the Walking Distance in Patients with Chronic Lower Limb Ischaemia. BioMed Res Int. 2016;2016:7515238. doi: https://doi.org/10.1155/2016/7515238

McDermott MM, Spring B, Tian L, Treat-Jacobson D, Ferrucci L, Lloyd-Jones D, et al. Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients with Peripheral Artery Disease: The LITE Randomized Clinical Trial. JAMA. 2021 Apr 6;325(13):1266-76. doi: https://doi.org/10.1001/jama.2021.2536.1276

Waddell A, Seed S, Broom DR, McGregor G, Birkett ST, Harwood AE. Safety of home-based exercise for people with intermittent claudication: A systematic review. Vascular Medicine. 2022;27(2):186-92. doi: https://doi.org/10.1177/1358863X211060388

Leslie R, May S, Scordis C, Isgar V, Poulton P, Garnham A. Outcomes following supervised exercise and home-based exercise for patients with intermittent claudication. Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing. 2022;40(4):157-61. doi: https://doi.org/10.1016/j.jvn.2022.09.006

Jansen SCP, Hoeks SE, Nyklíček I, Scheltinga MRM, Teijink JAW, Rouwet EV. Supervised Exercise Therapy is Effective for Patients with Intermittent Claudication Regardless of Psychological Constructs. European Journal of Vascular and Endovascular Surgery. 2022;63(3):438-45. doi: https://doi.org/10.1016/j.ejvs.2021.10.027

Pymer S, Ibeggazene S, Palmer J, Tew GA, Ingle L, Smith GE, et al. An updated systematic review and meta-analysis of home-based exercise programs for individuals with intermittent claudication. Journal of Vascular Surgery. 2021;74(6):2076-85. doi: https://doi.org/10.1016/j.jvs.2021.03.063

Afridi A, Rathore FA. What are the effects of different modes of exercise training for intermittent claudi-cation? – A Cochrane Review summary with commentary. Journal of Rehabilitation Medicine. 2021;53(4):2778. doi: https://doi.org/10.2340/16501977-2820

Hageman D, Fokkenrood HJ, Gommans LN, van den Houten MM, Teijink JA. Supervised exercise therapy versus physical therapy at home versus walking advice for intermittent claudication. The Cochrane Database of Systematic Reviews. 2018;4(4):CD005263. doi: https://doi.org/10.1002/14651858.CD005263.pub4

Sakibaev KS, Nikityuk DB, Alekseyeva NT, Klochkova SV, Tashmatova NM. Characteristics of muscle mass in women of different constitutions. Research Journal of Pharmacy and Technology. 2019;12(12):6193-7. doi: https://doi.org/10.5958/0974-360X.2019.01075.8

Doszhanova GN, Abduldayeva AA. Hygienic assessment of nutrition status of the population of the gerontological group. Gigiena i Sanitariya. 2017;96(11):1084-7. doi: https://doi.org/10.18821/0016-9900-2017-96-11-1084-1087

Mamontov I. Results of treatment for mirizzi syndrome. Klinichna Khirurhiia [Internet]. 2016Jan.1;(9):25-7. Available from: https://pubmed.ncbi.nlm.nih.gov/30265472/

Shakiyeva R, Abduldayeva A, Akhmetova K, Tuleshova G, Dosmambetova K, Maltabarova N, et al. The structure of a daily food ration of the inhabitants over 40 years old in the Republic of Kazakhstan. Iranian Journal of Public Health. 2018;47(8):1215-7.

Hajiyeva NN. Clinical presentations of pain syndrome depending on the grade of CNS lesions at newborns. Azerbaijan Medical Journal. 2008;3:50-2.

Sakibaev K, Kozuev K, Atabaev I, Alimbekova A, Argynbaeva A. Somatotypological Indicators of Physical Development in Residents of Kyrgyzstan. Iranian Journal of War and Public Health. 2022;14(3):279-85. doi: https://doi.org/10.29252/ijwph.14.3.279

Schapovalova O, Gorlova A, de Munter J, Sheveleva E, Eropkin M, Gorbunov N, et al. Immunomodulatory effects of new phytotherapy on human macrophages and TLR4- and TLR7/8-mediated viral-like inflammation in mice. Frontiers in Medicine. 2022;9:952977. doi: https://doi.org/10.3389/fmed.2022.952977

Altayeva AA, Issenova SS, Machtejeviene E, Bodykov GZ, Bishekova BN. Results of using the robson classification in Kazakhstan. Open Access Macedonian Journal of Medical Sciences. 2021;9:663-9. doi: https://doi.org/10.3889/oamjms.2021.6398

Hernandez S, Socas Fernández MDJ, Iturralde Y, Suáres Fernández A. The Effect of Deep Oscillation Therapy in Fibrocystic Breast Disease. A Randomized Controlled Clinical Trial. International Archives of Medicine [Internet]. 2018Feb.27;11. Available from: http://imedicalpublisher.com/ojs/index.php/iam/article/view/2789

Sakibaev KS, Nikityuk DB, Atabaev IN, Sattarov AE, Nuruev MK. Somatotypological features of the physique of ethnic Kyrgyz women of different ages. Asia Life Sciences. 2020;Supp 22(2):185-200.

Von Stengel S, Teschler M, Weissenfels A, Willert S, Kemmler W. Effect of deep oscillation as a recovery method after fatiguing soccer training: A randomized cross-over study. Journal of Exercise Science and Fitness. 2018;16(3):112-7. doi: https://doi.org/10.1016/j.jesf.2018.10.004

Jahr S, Schoppe B, Reisshauer A. Effect of treat-ment with low-intensity and extremely low-frequency electrostatic fields (Deep Oscillation) on breast tissue and pain in patients with secondary breast lymphoedema. Journal of Rehabilitation Medicine. 2008;40(8):645-50. doi: https://doi.org/10.2340/16501977-0225

Boisnic S, Branchet MC. Anti-inflammatory and draining effect of the Deep Oscillation device tested clinically and on a model of human skin maintained in survival condition. European Journal of Dermatology. 2013;23(1):59-63. doi: https://doi.org/10.1684/ejd.2012.1904

Ayazbekov A, Nurkhasimova R, Khudaibergenova SS, Zhunussov D, Zulpukharov A. Puberty Start of Girls Residing in Urban and Rural Areas of the Turkestan Region. Advances in Gerontology. 2022;12(1):47-55. doi: https://doi.org/10.1134/S2079057022010040

Mamed-zade GT. Congenital development disorder: the system of data collection. Georgian medical news. 2009;166:21-5. PMID: 19202212