Clinical Report: Efficacy of Ankle Pump Exercises with Anticoagulants for DVT

Overview

This systematic review evaluates the effectiveness of ankle pump exercises combined with anticoagulant therapy in preventing postoperative deep vein thrombosis (DVT).

Background

Postoperative DVT is a serious complication that can lead to significant morbidity and increased healthcare costs. While anticoagulant therapy is the standard for DVT prevention, its limitations necessitate exploring adjunctive non-pharmacological interventions. Ankle pump exercises may enhance venous return and provide additional protection against DVT.

Data Highlights

Key Findings

• 16 randomized controlled trials (RCTs) with 2,169 patients were included in the meta-analysis.
• Ankle pump exercises combined with anticoagulant therapy significantly reduced the risk of postoperative DVT (RR = 0.26).
• Active ankle pump exercises showed a more consistent effect (RR = 0.21) compared to passive or device-assisted exercises.
• Moderate heterogeneity was observed across studies (I2 = 60.9%).
• The overall quality of evidence was assessed as low due to methodological limitations and potential publication bias.

Clinical Implications

Clinicians should consider the limitations in the current evidence base regarding the use of ankle pump exercises in conjunction with anticoagulant therapy.

Conclusion

Further high-quality studies are needed to confirm the effectiveness of ankle pump exercises as an adjunct to anticoagulant therapy for preventing postoperative DVT.

Related Resources & Content

1. Evaluation of Intermittent Pneumatic Compression's Impact on Postoperative Edema in Patients Undergoing Autologous Femoropopliteal Bypass Surgery, 2010 -- Springer
2. Impact of Early Mobilization on Deep Venous Thrombosis Incidence Following Achilles Tendon Rupture, 2019 -- Springer
3. Effectiveness of Long-Term Graduated Compression Stockings After Deep Vein Thrombosis, 2026 -- Frontiers in Medicine
4. Recommendations | Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism, NICE
5. Effect of postoperative ankle pump exercises on the prevention of deep vein thrombosis, 2025 -- PubMed
6. Frontiers in Cardiovascular Medicine — Research on interventional treatment strategies for lower extremity deep venous thrombosis based on real-world data
7. NICE Guidelines on VTE Prevention
8. Meta-analysis of Ankle Pump Exercises in Postoperative Settings
9. Effectiveness of non-instrumental early mobilization to reduce the incidence of deep vein thrombosis in hospitalized patients: A systematic review and meta-analysis - PubMed
10. Antithrombotic prophylaxis following total knee arthroplasty: a level I Bayesian network meta-analysis - PubMed