A study from Adams et al. 2023 aimed to evaluate the effectiveness of a standardized osteopathic technique, specifically the pedal pump combined with myofascial release, in reducing fluid volume in the lower extremities of healthy individuals. This technique may have implications for treating conditions such as peripheral edema and venous stasis.
The study involved 30 healthy subjects who underwent a pedal pump treatment protocol, with pre- and post-treatment lower limb volume measurements taken using a volumetric gauge. The data were analyzed using paired t-tests to assess statistical significance.
The findings indicated a statistically significant reduction in limb volume, with a mean decrease of.63 mL (p<0.001). The study observed individual variations in volume change, with some subjects reporting transient effects post-treatment, primarily related to fluid dynamics and not the technique itself.
The study concluded that the pedal pump technique can effectively reduce lower extremity fluid volume in healthy individuals. This finding supports its potential application in clinical settings for patients with fluid retention issues, enhancing standard treatment protocols in osteopathy.
A notable limitation of the study was the absence of a control group, which could have helped isolate the effects of the pedal pump technique from other factors, such as positioning and leg elevation. The study’s reliance on a healthy participant cohort also raises questions about the generalizability of the findings to clinical populations with fluid retention disorders.
Conclusion for your clinic
Osteopaths may integrate the pedal pump technique into their practice to treat patients experiencing conditions related to excess fluid, such as lymphedema and venous stasis.
How to do it:
- Patient Preparation: The patient lies supine on an examination table.
- Myofascial Release: Initially, a myofascial release technique is performed on the thoracic inlet to facilitate lymphatic drainage. This involves:
Placing both hands over the thoracic inlet.
Engaging the myofascial tissues and assessing motion in three planes (cephalocaudad, left to right, and rotation).
Using deep breathing to assist in the release process.
Moving the tissues away from restrictions and then directly into barriers to achieve a release. - Pedal Pump Technique: Following the myofascial release, the pedal pump is applied for a duration of about 5 minutes. This involves:
Gentle, rhythmic movements applied to the feet and lower legs.
Techniques aimed at promoting fluid movement back into the lymphatic system and enhancing its flow toward the central circulatory system. - Measurement and Evaluation: Pre- and post-treatment measurements of lower limb volume are conducted using a volumetric water gauge to assess the effectiveness of the treatment. The average reduction in lower limb volume recorded in studies was approximately 45.63 mL post-treatment, indicating the protocol’s efficacy in fluid reduction 1[].
- Post-Treatment Feedback: A follow-up survey is conducted to gauge the patient’s subjective experience of the treatment, including perceived effectiveness and comfort.
- Considerations: The protocol is generally well-tolerated and is suitable for healthy individuals without contraindications such as acute respiratory issues, infections, or fractures.
Adams, J. S., Parikh, S. H., Goodwin, B. J., & Noll, D. R. (2023). Does the osteopathic pedal pump reduce lower limb volume in healthy subjects?. Journal of osteopathic medicine, 123(4), 201–206. https://doi.org/10.1515/jom-2022-0127
