Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

First Advisor

Heather Barnhardt

Date of original Performance / Presentation

January 2024

Publication Date / Copyright Date

1-1-2024

Abstract

Abstract Introduction Compression therapy manages edema and chronic venous disease (CVD). Current classification relies on focal interface pressure (IP) at the limb’s distal aspect. However, spatial and temporal performance characteristics of specific compression methods are poorly understood. The study aimed to quantify the in vivo IP and observe changes in biophysical outcomes after applying three distinct compression applications. Methods A prospective, randomized study design comparing three compression conditions: longitudinal elastic stockinette (EW), a two-layer cohesive wrap box set (CF), and a combination of the two (BO) was conducted. A piezoresistive (PR) sensor was used to measure focal IP and map IP distribution at different time points. Advance imaging tools tracked limb volume and three other tissue microcirculation measures. The study comprised three parts: Part I (n=40) and Part II (n=20) captured in vivo IP and biophysical data pre- and post-compression application in healthy individual and those with underlying pathology, respectively. Part III (n=19) documented the biophysical effects of compression in patients with lower extremity ulcers. Statistical analysis assessed differences within and between compression conditions in Part I and II, while descriptive data detailed outcomes for Part III. Results Significant findings: 1) Spatial and temporal IP varied between compression conditions and study groups. IP increased with upright position but decreased over time, even within 10 minutes of wear. Medial to lateral IP distribution variations were visualized in some pressure maps. 2) Limb volume reduction was observed across all compression conditions and study groups. BO showed a significant reduction compared to CF in part II (p=.042). 3)Local tissue water content (LTWC) decreased under the compression application, however, the area of greatest reduction varied. Patients with underlying vascular pathology exhibited an increased LTWC adjacent to the compression condition. 4) Relative temperature difference was observed between the compressed area and adjacent regions 5) Tissue oxygenation increased under the compression condition but not in adjacent areas. Conclusion The observations offer a fresh perspective on compression interventions highlighting the dynamic interactions influenced by compression textile characteristic and patient context. Imaging devices may offer new avenues to define the unique biophysical impact of distinct compression applications.

Disciplines

Physical Therapy

Keywords

Compression Therapy; Interface Pressure; Limb Volume; Local Tissue Water Content; Long Wave Infrared Thermography; Near Infrared Spectroscopy

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