Hey neuro peeps.
I have a neuro adjacent concern and hoping that someone can point me in the
right direction in the literature.
I work at an inpatient rehab facility, and we have a few physicians that are
incredibly conservative when it comes to physical therapy with patients with
either active VTE or history of VTE, even after anticoagulation. Specifically
with electrical stimulation. We treat patients with SCI and CVA and electrical
stimulation is a very common intervention. They do not want us to do electrical
stimulation in ANY patient with a VTE or history of VTE.
When we push them, they keep saying that "the risks vs benefits aren't there"
We want to show them that there is no difference in risk of a clot dislodging
with stim vs ambulation or any other means of increasing venous blood flow.
They allow us to ambulate patients, complete exercise, etc. But they have a
very specific aversion to estim, not even allowing stim on the lower
extremities with a patient that has a VTE in the upper extremity.
I have found a TON of articles about stim being used for VTE prophylaxis, but I
am hoping to find something that shows risk of muscle contraction and venous
blood flow from stim is no different than muscle contraction and venous blood
flow with all other activities.
Any help that you can provide would be appreciated, or if you have other
suggestions of people to reach out to, I would be grateful.
Andrew Moul, PT, DPT, NCS
Board Certified Clinical Specialist in Neurologic Physical Therapy
Assistant Professor - Clinical
Eugene Applebaum College of Pharmacy and Health Sciences
259 Mack Ave. Detroit, MI 48201 Office #2337
Pronouns: he, him, his
In addition to my position at Wayne State University I am a practicing
clinician at the Rehabilitation Institute of Michigan. If my email response is
delayed please forgive me as I am likely engaged in patient care. I promise to
give your email thoughtful consideration as soon as possible.