APTA Supports Surgeon General's "Call To Action" To Prevent Deep Vein Thrombosis And Pulmonary Embolism

Main Category: Vascular
Also Included In: Rehabilitation / Physical Therapy
Article Date: 30 Sep 2008 - 3:00 PST

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The American Physical Therapy Association (APTA) supports the recent "Call to Action" by Acting Surgeon General Steven K Galson, MD, MPH to reduce the number of cases of deep vein thrombosis and pulmonary embolism in the United States.

According to Susan Scherer, PT, PhD, associate professor of physical therapy at Regis University in Denver and member of the American Physical Therapy Association's Cardiovascular and Pulmonary Section, blood clots, called deep vein thrombosis (DVT), can occur after periods of being immobile, such as on long plane flights.

Scherer notes that the risk of DVT increases during travel of 8 hours or more(1) and that an estimated 10 percent of passengers on long flights may develop a DVT.(2) A clot in the legs may dislodge and travel to the lungs, called pulmonary embolus. The symptoms of leg DVT include swelling in one or both legs and tenderness in the calf. Symptoms of a pulmonary embolus include shortness of breath and a high heart rate. "People who experience any of these symptoms should always see the doctor, especially if they occur following a long period of immobilization," she says.

Compression stockings(2) are recommended to help reduce the risk of DVT. "The compression helps keep excess blood from remaining in the leg veins, helping to prevent clot formation," says Scherer. Physical therapists also suggest that when you have little room to move and stretch, do some simple, seated exercises to keep the blood flowing, the joints mobile, and the muscles relaxed while en route. The APTA "In Flight Fitness Guide," featuring a selection of recommended exercises, can be found on APTA's Consumer Web page at http://www.apta.org/consumer.

"Simple exercise can help prevent other typical symptoms experienced by people who fly, including leg cramping, toe cramping, and general lower-body aching," says former APTA President Marilyn Moffat, PT, PhD, DPT. "Sitting still for long periods may lead to swelling of the feet, which becomes obvious to many passengers when they try to put their shoes back on at the end of their flight," Moffat says.

APTA suggests that passengers not stay seated for the duration of the flight and recommends that passengers walk up and down the aisle of the plane every hour or so to work the leg muscles and ease the back - that is, if the captain has turned off the "Fasten Seat Belt" sign.

"Performing these exercises will keep the leg muscles from contracting and will help relieve stiffness during the flight. The exercises also will help prevent fluid build-up in the legs, and stretching the back and the muscles around the torso will prevent stiffening," says Moffat. Moffat notes that if you have an existing back problem, appropriate guidance should be given to you by your physical therapist before any extensive flying.

"Sitting in such a cramped position also puts a lot of stress on the lower back, especially for people who have pre-existing back problems. If you have brought along hand luggage or a rolling case that fits under the seat, use them as foot rests to elevate your feet so that your knees are slightly higher than your hips when you are sitting," suggests Moffat.

Another consideration while flying is the dehydration that occurs from the high altitudes at which planes fly and the dry, pressurized cabin air. These conditions may lead to muscle cramping and aching, so APTA advises passengers to drink plenty of water before and during the flight.

For people who are post-operative, physical therapists can help patients return to physical activity as soon as possible in order to help prevent occurrence of a DVT.

Physical therapists are health care professionals who diagnose and manage individuals of all ages, from newborns to elders, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.

APTA is a national organization representing physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can visit http://www.findapt.usto find a physical therapist in their area, as well as http://www.apta.org/consumer for physical therapy news and information.

References

1) Aryal KR, Al-Khaffaf H. Venous thromboembolic complications following air travel: what's the quantitative risk? A literature review. Eur J Vasc Endovasc Surg. 2006;31:187-99.

2) Scurr JH, Machin SJ, Bailey-King S, Mackie IJ, McDonald S, Smith PD. Frequency and prevention of symptomless deep-vein thrombosis in long-haul flights: a randomised trial. Lancet. 2001;357:1485-9.

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