Exercise-based interventions for prevention and management of deep vein thrombosis: A systematic review

ObjectiveTo evaluate the effectiveness and safety of exercise-related interventions for the prevention and management of deep vein thrombosis (DVT).Data sourcesPubMed, Web of Science, and Google Scholar were searched from inception to 31 December 2024 using terms related to exercise, physical activity, DVT, and venous thromboembolism. Reference lists of eligible studies and relevant systematic reviews were also screened. English- and Spanish-language studies were considered.Review methods11 primary studies, reported in 12 publications, met the eligibility criteria: seven evaluated preventive strategies or venous-haemodynamic outcomes in participants without established DVT, three evaluated mobilisation or supervised exercise following objectively confirmed acute DVT, and one evaluated supervised exercise in established post-thrombotic syndrome. Two reviewers independently extracted study characteristics, interventions, comparators, outcomes, safety data, and results. Risk of bias was assessed using design-specific tools, and findings were synthesized narratively by clinical setting.Data synthesisExercise interventions produced favourable changes in surrogate lower-limb venous-haemodynamic measures, while regular sports participation was associated with lower odds of a first venous thrombosis. In acute DVT, mobilisation alongside anticoagulation and compression did not appear to increase thromboembolic complications. Symptomatic improvements could not be separated from compression, and supervised exercise did not improve recanalisation. In established post-thrombotic syndrome, supervised exercise improved disease-specific quality of life, although the reduction in Villalta score was not statistically significant. No universal start time was established. Evidence was limited by small samples, heterogeneity, and methodological concerns.ConclusionsExercise may favourably modify surrogate venous haemodynamics. In selected patients with acute DVT receiving anticoagulation and compression, mobilisation did not appear to increase thromboembolic complications, although its independent effects and optimal timing remain uncertain. Supervised exercise may improve disease-specific quality of life in established post-thrombotic syndrome. Larger randomized trials using standardized interventions and clinically relevant outcomes are required.