1. This systematic review found that early mobilization in the acute phase following a deep vein thrombosis (DVT) was associated with a significant reduction in post-thrombotic syndrome (PTS) severity after two years and improvements in quality of life and pain reduction.
2. Furthermore, none of the included studies reported an increased risk of PTS due to physical activity.
Evidence Rating Level: 1 (Excellent)
Post-thrombotic syndrome (PTS) is a set of symptoms related to impaired venous outflow that commonly occurs following a deep vein thrombosis (DVT). PTS is a significant burden on patients, resulting in a lower quality of life (QoL) and increased medical needs. Many fear that exercise in the acute phase following a DVT can be harmful. Previous findings have suggested that exercise following a DVT can help prevent the development of PTS. Still, further research is necessary to evaluate the long-term effects of exercise post-DVT on symptoms and PTS. This systematic review sought to assess the direct and long-term effects of physical activity in patients following a DVT.
Of 3,154 identified records, 10 studies were included from July 2007 to March 2022. Studies were included if they were published in English and investigated the effects of physical activity on the incidence of PTS, indicators of PTS, or QoL in DVT patients. Studies were excluded if more than half of their study populations had causes of chronic venous insufficiency other than a DVT. The study quality was assessed using the GRADE framework, and the review was carried out according to PRISMA guidelines. The primary outcome was the association between physical activity and the incidence or symptoms of PTS.
The results demonstrated three main types, timings, and durations of exercise following a DVT: early mobilization in the acute phase, short-duration exercise one year post-DVT, and prolonged exercise during follow-up after a previous DVT. Overall, early mobilization in the acute phase was associated with a significant reduction in PTS severity after two years and also resulted in improvements in QoL and pain reduction. Prolonged exercise was also associated with improvements in QoL and venous insufficiency. Furthermore, none of the included studies reported risks of worsening symptoms or PTS related to physical activity. However, the review was limited by many of the included studies using surrogate markers for PTS, such as joint flexibility, which is not necessarily associated with PTS. Nonetheless, this study suggested that physical activity is a safe and effective method for improving symptoms and decreasing the risk of PTS following a DVT.
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