[Musculo-venous pump in the elderly]

We study the musculo-venous pump in an elderly population, free of venous disease, by use of a digitized photoplethysmograph. We measure the venous refilling time (To) and the venous drainage (Vo) during active and passive movement. In the first part, we measure Vo and To during active and passive ankle flexions among 17 patients (34 limbs) aged 82.2 years. These variables are compared to the results of the same measurements obtained among 15 young adults aged 45.1 years (30 limbs). We find that To and Vo are significantly lower in the oldest population (To j 35.9 +/- 4.8 sec, To aged 16.1 +/- 5.2 sec, p < 0.001, Vo j 4.98 +/- 1.1%, Vo ag 2.97 +/- 1%, p < 0.001). In the second part of this work, a passive massage of the calf is substituted to the ankle flexions. This technique is applied to 19 elderly people aged 80.4 years (37 limbs) compared to 6 young adults aged 24 years (12 limbs). In these conditions the comparison is no more in favour of the younger group (To j 37 +/- 7.5 sec, To ag 30.6 +/- 4.1 sec, Vo j 4.03 +/- 1.5%, Vo ag 3.8 +/- 0.06%). The values measured in the elderly group are in the range of normal values. We conclude that senescence does not alter the venous system itself. The present work confirms the influence of extravascular factors as muscles, understanding and coordination of the motions, articular flexibility, on the performance of the musculo venous pomp. As far as possible, the muscular and articular activity has to be encouraged in elderly people in order to reduce the venous stasis.