Objective: To evaluate accurately the calf muscle pump in patients wit
h venous insufficiency using foot vein pressure measurements during th
ree different exercises. Design: Prospective study in three groups, co
mparing patients with venous disease with controls. Setting: Second De
partment of Surgery, Tottori University Faculty of Medicine.Patients:
Twenty normal legs, 29 legs previously affected by deep vein thrombosi
s and 36 legs with primary varicose veins. Main outcome measures: The
foot vein pressure was measured during ankle dorsiflexions, knee-bendi
ng and walking on the spot at 40 paces per minute during which minimum
ambulatory venous pressure (AVP) and venous refilling time (VRT) were
assessed. Results: The three groups differed significantly from each
other in AVP and VRT after dorsiflexion and in AVP during walking on t
he spot, but not after knee-bending. Conclusion: Dorsiflexion is the m
ost useful exercise distinguishing various severities of venous insuff
iciency, but walking on the spot is more useful for accurately evaluat
ing the calf muscle pump.