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Related Experiment Video

Updated: Mar 2, 2026

Ex Vivo Assessment of Contractility, Fatigability and Alternans in Isolated Skeletal Muscles
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Optimizing calf muscle pump function.

Christopher R Lattimer1,2,3, Claude Franceschi4, Evi Kalodiki1,2,3

  • 11 Josef Pflug Vascular Laboratory, Ealing Hospital, Middlesex, UK.

Phlebology
|May 23, 2017
PubMed
Summary

The body weight transfer maneuver is a superior method for assessing calf muscle pump function compared to the tip toe maneuver, showing a significant increase in ejection fraction. This finding suggests exercises involving weight transfer are more beneficial for calf pump optimization.

Keywords:
Active foot dorsiflexioncalf muscle pump functionphysiologyplethysmographyvenous flow

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Area of Science:

  • Vascular Physiology
  • Biomechanical Analysis

Background:

  • The tip toe maneuver is considered the gold standard for assessing calf muscle pump function using plethysmography.
  • Previous research has not definitively compared various maneuvers for their effectiveness in evaluating calf muscle pump capacity.

Purpose of the Study:

  • To compare the efficacy of the tip toe maneuver, dorsiflexion maneuver, and body weight transfer maneuver in measuring calf muscle pump function.
  • To determine which maneuver yields the highest ejection fraction, indicating optimal calf muscle pump activation.

Main Methods:

  • Analysis of 66 archived air-plethysmography tracings from 22 legs.
  • Measurement of calf muscle pump performance via calf volume reduction after each maneuver.
  • Comparison of ejection fraction percentages across the three tested maneuvers.

Main Results:

  • The body weight transfer maneuver demonstrated a significantly greater ejection fraction (59.7%) compared to the tip toe maneuver (42.6%).
  • No significant difference in ejection fraction was observed between the tip toe and dorsiflexion maneuvers.
  • All maneuvers exhibited excellent repeatability, with confidence intervals of ±1.2 to ±1.6 for ejection fraction.

Conclusions:

  • The body weight transfer maneuver is a more effective method for evaluating the maximal potential of the calf muscle pump.
  • This maneuver showed a 40.1% relative increase in ejection fraction compared to the tip toe maneuver.
  • Exercises promoting body weight transfer may be more crucial for enhancing calf muscle pump function than those focusing solely on ankle movements.