TREATMENT AND PHYSICAL THERAPY FOR VARICOSE VEINS IN YOUNG PATIENTS

Abstract

Chronic venous disease (CVD) is characterized by a wide range of disorders of the venous system. Varicose veins (VV) are a common clinical manifestation of CVD, especially in the lower extremities. Previous histopathological studies have identified a number of changes observed in the venous wall of patients with VV that affect their structure and behaviour and may lead to valve dysfunction and venous reflux in young patients with CVD. Metabolic changes in the veins are a critical biological mechanism that helps to understand the pathogenesis of CVD. The aim of the study was to determine the effectiveness of a combination of treatment and physical therapy for varicose veins. This study used evidence-based literature sources, including medical articles in peer-reviewed scientific journals with the results of clinical studies and reviews on the effectiveness of combining treatment with physical therapy and generalizing best practices in rehabilitation for varicose veins.The results of the study showed that for an adequate treatment plan, a complete examination protocol based on transabdominal and transvaginal examination is suggested to exclude venous obstruction, thrombotic or not, and to confirm the presence of varicose veins in the pelvic adnexal area. Sequential pneumatic compression increases venous blood flow and improves quality of life, while comprehensive decongestant therapy reduces limb volume and pain intensity, and improves activities of daily living. The analysis of the literature allowed us to highlight physical activity as an adjunct to compression treatment for wound healing and relapse. Physical activity interventions can be represented by resistance exercises, ankle and/or foot range of motion exercises, aerobic exercises, and walking. Manual lymphatic drainage reduces venous reflux, edema, clinical severity, symptoms, and improves quality of life. Kinesiotaping improves peripheral venous blood flow, ankle joint function, reduces edema, pain, improves quality of life, reduces venous symptoms and severity of venous disease, normalizes mental health. The combined use of these methods is proposed in the symptomatic treatment of varicose veins. However, further studies are needed to effectively assess the functional state of the body in varicose veins and determine the parameters of its treatment. Treatment of varicose veins includes compression and elevation of the lower extremities, as well as exercise, walking, and resistance training to improve the pumping function of the calf muscle. Additional physical therapy methods may include balneotherapy and kinesiotherapy. Conclusion. In varicose veins, weight control and treatment of concomitant diseases are recommended. Compression therapy combined with aerobic exercise, resistance exercise, and ankle and/or foot mobility exercises increase the effectiveness of varicose vein treatment.