Chronic venous disorders (CVD) often cause long-term disability for those who experience the worst manifestations of CVD: disabling pain and non-healing leg ulcers. Such disabilities have significant socioeconomic implications in terms of lost work days and wages, decreased productivity, and ultimately increased health cares costs that deteriorate the well-being and quality of life for those who have CVD-induced illnesses. Because no reliable preventive mechanism exists for CVD, this study proposes a preventive, self management cryotherapy intervention that targets inflamed skin of populations with CVD at highest risk of developing chronic leg ulcers. The proposed cryotherapy intervention will utilize a randomized controlled clinical trial to develop a method to reduce clinical symptoms by improving existing therapy-it is not a treatment for CVD itself. In the proposed pilot feasibility study, subjects will be randomized to two groups: the ? cryotherapy intervention group (n=30) who will receive a four-week, cryotherapy gel wrap applied daily to affected skin of the lower legs in addition to the standard of care (usual care). The control group (n=30) will receive the usual care of compression wraps or stockings applied to the lower legs and daily leg elevation. With this method, improvement of skin microcirculation, reduced leg pain, and improvement in quality of life will be observed. The following aims will test the hypothesis: ? Aim 1. Evaluate the feasibility of the novel intervention including treatment fidelity, subject training, safety, and side effects associated with equipment and recruitment efforts and further refine the intervention protocol, including questionnaires used in our previous studies.
Aim 2. Estimate variability of outcome measurements and effect sizes needed to calculate sample size for a subsequent larger, adequately powered, randomized clinical trial of the efficacy of the novel cryotherapy intervention. ? Aim 3. Investigate the presence of a preliminary """"""""signal"""""""" of clinical efficacy of the experimental treatment by evaluating trends toward statistical significance for the hypothesis that the experimental group will experience greater reduction in skin temperature and blood flow, greater improvement in pain, and greater improvement in quality of life. It is predicted that this novel cryotherapy model and method will significantly improve the health and quality of life for those with CVD and related disorders, and that the intervention will become the standard of care for CVD. In addition, the method will, over time, reduce health care costs associated with treating poor CVD outcomes. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NR010604-02
Application #
7494631
Study Section
Nursing Science: Adults and Older Adults Study Section (NSAA)
Program Officer
Huss, Karen
Project Start
2007-09-11
Project End
2009-11-30
Budget Start
2008-06-01
Budget End
2009-11-30
Support Year
2
Fiscal Year
2008
Total Cost
$179,033
Indirect Cost
Name
Medical University of South Carolina
Department
Type
Schools of Nursing
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29425
Kelechi, Teresa J; Mueller, Martina; Zapka, Jane G et al. (2012) Cryotherapy and ankle motion in chronic venous disorders. Open J Nurs 2:379-387
Matutina, Robin E; Mueller, Martina; Kelechi, Teresa J (2011) Racial differences in pain reports between Black and White participants with chronic venous disorders treated with cryotherapy compared to usual care. Ethn Dis 21:451-7
Kelechi, Teresa J; Mueller, Martina; Zapka, Jane G et al. (2011) The effect of a cryotherapy gel wrap on the microcirculation of skin affected by chronic venous disorders. J Adv Nurs 67:2337-49
Kelechi, Teresa J; Good, Angela; Mueller, Martina (2011) Agreement and repeatability of an infrared thermometer. J Nurs Meas 19:55-64
Kelechi, Teresa J; Watts, Ashlee; Wiseman, Jan (2010) Recruitment strategy effectiveness for a cryotherapy intervention for a venous leg ulcer prevention study. J Wound Ostomy Continence Nurs 37:39-45