Exercise May Improve Complications of Deep Vein Thrombosis

A six-month exercise training program designed to increase leg strength, leg flexibility, and overall fitness may improve post-thrombotic syndrome, a frequent, chronic complication of deep vein thrombosis, according to findings from a pilot study published in CMAJ (Canadian Medical Association Journal).

Chronic post-thrombotic syndrome develops in up to one half of patients with deep vein thrombosis (DVT), who often experience leg pain, heaviness, swelling, water retention, hyperpigmentation, and varicose veins and leg ulcers.

"Given that effective treatments are lacking, new approaches to managing post-thrombotic syndrome are needed,” said Susan Kahn, MD, professor of medicine at McGill University in Montreal, Canada, and one of the study’s co-authors, in a statement. "We performed a pilot trial to obtain data on the effectiveness of exercise training to treat post-thrombotic syndrome and to assess the feasibility of performing a multicentre study to address this question.”

In the multicenter-based study, patients were randomized to receive exercise training through a six-month trainer-supervised program, or control treatment, which included an education session with monthly phone follow-ups. The primary outcomes measured were change from baseline to six months in venous disease-specific quality of life, as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life (VEINES-QOL) questionnaire, and severity of post-thrombotic syndrome, as measured by scores on the Villalta scale, in the exercise training group versus the control group. The study also measured change in generic quality of life, category of severity of post-thrombotic syndrome, leg strength, leg flexibility, and time on treadmill.

Of 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. According to the authors, exercise training was associated with improvement in VEINES-QOL scores and improvement in scores on the Villalta scale.

"The findings of our small trial should be interpreted with caution and require confirmation in a larger study," wrote the authors. "As most of our patients were young, well-educated and active, the results obtained may not be generalizable to patients with post-thrombotic syndrome at other centres."

The authors conclude that exercise training may improve post-thrombotic syndrome and should be evaluated as a treatment in further clinical trials.

For more information:

• CMAJ—Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial
• MDNG: Hospitalist—Spotlight on VTE Prevention
• CME—Deep Vein Thrombosis in Focus: Expert Perspectives on Reducing the Burden of Venous Thromboembolism

Do you recommend exercise training programs to patients with deep vein thrombosis? If not, what concerns do you have?