Changes in joint mobility with the progression of chronic venous disease

BACKGROUND: Limited range of ankle movement can contribute to the insufficiency of the calf muscle pump. The objective of the present study was to identify the stages of CEAP in elderly women with chronic complaints of lower limb edema, evaluate the goniometric variation in each stage of CEAP and compare whether there is a difference in joint mobility. METHODS: Sixty patients (eight men and 52 women) 23 to 78 years of age (mean: 43.36 years) with varicose veins were evaluated at the Belczak Clinic in Maringá, Brazil. The same examiner evaluated all patients and the goniometric readings were performed on all patients by a physiotherapist. The participants were divided into four groups based on the CEAP stage: CEAP C3, CEAP C4, CEAP C5 and CEAP C6. RESULTS: The Mann-Whitney U Test revealed no significant difference in median ROAM between C3 and C4 (P=0.1). However, significant differences were found between C3 and C5 (P=0.007) as well as between C3 and C6 (P=0.03). No significant differences were found in the comparisons of C4 X C5, C4 X C6 or C5 X C6. CONCLUSIONS: The progression of chronic venous insufficiency is associated with the deterioration of ankle mobility, which emerges significantly in CEAP stage C5, but changes are already evident in CEAP stage C4.