Effects of Aerobic Exercise with Manual Lymphatic Drainage in Chronic Venous Insufficiency Patients

<b><i>Background:</i></b> This study aimed to examine the effects of aerobic exercise added to manual lymphatic drainage (MLD) on venous hemodynamics, inflammatory-vascularization markers, local tissue water percentages (LTW%), calf muscle endurance, exercise capacity, and quality of life (QoL) in patients with chronic venous insufficiency (CVI). <b><i>Methods:</i></b> Participants were randomly assigned to one of two groups: (1) MLD group, which received MLD 5 days per week, and (2) MLD + aerobic exercise group, which received the same MLD plus aerobic exercise (30-minute walking sessions, three times per week) for 6 weeks. Venous hemodynamics was evaluated using Doppler ultrasonography. Inflammatory-vascularization markers, such as interleukin-6, vascular endothelial growth factor-A (VEGF-A), and some blood values were examined. LTW%, calf muscle endurance, exercise capacity, and QoL were evaluated with MoistureMeterD device, heel-rise test, 6-minute walk test (6MWT), and Venous Insufficiency Epidemiological and Economic Study on Quality-of-Life Questionnaire/Symptoms (VEINES-QOL/Sym), respectively. <b><i>Results:</i></b> There was a significant increase in venous blood flow in the right great saphenous vein (GSV), VEGF-A, and QoL and a significant decrease in the diameter of the right GSV, monocytes, and LTW% in both groups. However, there was no superiority between groups. There was a significant increase in calf muscle endurance and exercise capacity in the group that added aerobic exercise compared to the MLD group (<i>p</i> < 0.05). <b><i>Conclusions:</i></b> Since positive effects of MLD on venous flow, edema, and QoL have been found, MLD can be used in physiotherapy programs for CVI. Adding aerobic exercise to MLD is an effective treatment for CVI by increasing calf muscle endurance and exercise capacity, in addition to these positive effects.