Estudio experimental clínico-funcional mediante dos modalidades de vendaje neuromuscular (kinesio taping) en el paciente con riesgo evolutivo de insuficiencia venosa

Résumé

Chronic venous insufficiency (CVI) is a prevalent pathology, with some typical signs and symptoms that cause significant socio-economic cost and impact on quality of life. Pain, despite being a recurrent symptom in this pathology, has scarcely been studied. Compression therapy is the standard method for non-invasive CVI treatment; however, it has been indicated that the patient seldom follows this type of treatment. Kinesio Taping is a new technique of neuromuscular bandaging that can affect muscular and joint function, decrease pain and influence lymph and venous circulation. No previous studies have been found on the application of this bandaging on patients with CVI. The main objectives of this doctoral thesis are to describe the characteristics of pain in postmenopausal women with CVI and its relationship with risk factors; and assessing the efficacy of two application of neuromuscular bandaging (Kinesio Taping [KT]) on musculoskeletal alterations, specific venous symptomatology, pain, severity and quality of life in postmenopausal women at short-term risk of severe CVI (CEAP C1-C3). A total of 259 patients with initial CVI and 40 healthy women that fulfilled the criteria for inclusion participated in the studies for this thesis. The main findings and conclusions are: a) postmenopausal women with CVI present intense pathological pain and lowered nociceptive thresholds, suggesting that there is central sensitization; the pain is principally related with peripheral venous reflux and with the pain and functional limitation induced by knee or hip osteoarthritis; b) the use of the Pain Matcher device seems to be a valid technique for assessing chronic venous pain; c) applying standardised bandaging with KT in postmenopausal women at short-term risk of severe CVI can reduce the specific venous symptomatology, pain and clinical severity and increase the bioelectric activity of the gastrocnemius muscle; d) the method of mixed KT-peripheral compression seems to improve ankle dorsiflexion during walking, gait parameters, peripheral venous flow, specific venous symptomatology, foot and malleolar oedema, pain, clinical severity and quality of life,while it increases the general state of health slightly, in postmenopausal women at risk of short-term severe CVI; and e) KT can have a placebo effect on venous pain. Our findings help to clarify the mechanisms involved in pain from CVI and support the use of KT as an alternative bandaging technique for managing the symptoms associated with venous pathology in initial stages.