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Water immersion for leg swelling

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    Adam Karalus, Physician Assistant Student at Daemen College (contributor to Vein News and www.VeinsVeinsVeins.com)

    Water immersion is used in some countries to reduce leg swelling as an alternative to medical therapy.  In mineral spas, this is called balneotherapy.

    Giovsnni Mosti and Alberto Caggiati from the Angiology Department, MD Barbantini Clinic, Lucca, Italy and the Anatomy Department, Sapienza University of Rome, Rome, Italy have investigated the role of water immersion therapy on leg edema and epifascial thickness and have compared these data with those achieved after continuous walking on ground.

    The study was published in Phlebology (full reference below). 

    What are the study methods?

    Randomized controlled trial.

    What was the study population?

    On three consecutive days, 14 otherwise healthy volunteers (9 females, 5 males, mean age 53 ± 10 years) affected by occupational edema (OE), defined as the edema developing during the time period of the working day and disappearing overnight, stayed standing immobile in a swimming pool for 30 minutes (30'), continuously walking again for 30' in the same pool and walking on ground for 30' without interruption in a randomized sequence.

    What were the study parameters?

    Leg volume, ankle circumference and epifascial thickness of both legs were assessed each day before and after each intervention.

    What were the study results? 

    Leg volume showed a median reduction by 4.20% (p = 0.0002) after 30' of immobile standing immersion and by 6.50% (P < 0.0001) when the patients walked in the pool.

    Ankle circumference showed a median reduction by 2.89% (p = 0.02) with the subjects staying standing still in water and by 5.98% (p = 0.0002) after 30' walking in the pool.

    Epifascial thickness showed a median reduction by 24.35% (P < 0.0001) when the volunteers remained standing still and by 32.66% (P < 0.0001), when walking in water.

    Leg volumetry showed a median reduction by 0.20% (p = 0.375) after walking on ground for 30'.

    Ankle circumference and epifascial thickness did not show any difference walking on ground compared to baseline situation.

    What are the conclusions of the study ?

    This study showed that 30' of warm immersion, especially when associated with walking, reduced leg volume in otherwise healthy subjects with occupational edema and that walking outside the water did not.

    Reference:  Giovsnni Mosti and Alberto Caggiati.  The effects of water immersion and walking on leg volume, ankle circumference and epifascial thickness in healthy subjects with occupational edema.  Phlebology 2021; Jan 6;268355520984065 (online print).