Circulation boosters, good or bad?

The ASA have just issued an adjudication on the Circulation Booster which concluded that it could not substantiate the claims made. I guess this concludes the conversation one and for all !

http://www.asa.org.uk/ASA-action/Adjudications/2011/6/High-Tech-Health-Ltd/TF_ADJ_50690.aspx

 

Yeah get asked by patients all the time re: circulation booster....
being a bit naive here, but doesnt this kind of products need their proclaimed benefits substantiated before market release otherwise they can only advertise it as 'may'

 

I have been thinking about this and reading all the scientific references on the website…all the references were about venous issues and not about approving the arterial circulation.

As I understand it, the Circulation Booster works by electrically stimulating the muscles to help the venous return pump. Going for a walk is going to stimulate them a lot more and be a lot better for you and will have added benefits like actually improve the arterial circulation, prevent osteoporosis, etc etc …. I just do not get it.

If this device encourages people to sit down and have the "circulation" stimulated, is it not then dangerous for public health in encouraging inactivity and increasing the risk for things like osteoporosis?

 

Hi everyone,

Just registered here so I could post about this product.

I read through the document they have on the website and I have the following question/comment that someone might comment on if they get a chance to look through the doc.
The doc is here :
http://www.circulationbooster.ie/media/site_assets/pdf/Circulation-Booster-clinical-study.pdf

Figure 1 shows the protocol and this is what I have a problem with. Why have the subjects recieved 40mins of rest compared to 10mins of stimulation? If you look at Figure 2 you will see that the increase in volume with the Circulation Booster was ~30% of that without. So after 10 mins you get 30% of the pooling. So if this continues to 40min like the control static test would you get 30*4 = 120% of the static case?

i.e. is the circulation booster actually worse than nothing?

All the best
IKN

 

IKN, not sure I understand what you are saying ... but reading that paper throws up lots of issues:

1. It was written up in 2008. I did a medline search and it has not been published following peer review
2. Only 12 subjects; all healthy with no circulation problems
3. Nothing in the protocol is justified for its rationale (ie why 40mins?; why 10 mins; etc)
4. No control group, so we do not know if there was any placebo effect from a 'dummy' circulation booster
5. They used repeated t-tests for the analysis massively increasing the chance of a type 2 statistical error; thats very very bad and you can not trust any of the results just based on that alone

 

Craig

1. Yes, this looks like a journal paper, but doesn't seem to be one. Also, look at the stimulation applied in the other papers listed, they had completely different stimulation setups, I see no evidence to suggest this device is doing a comparable job.

2. All healthy subjects - as exploratory research its probably good to start with healthy subjects (first we do no harm) but clearly research with patients with circulation problems is necessary.

3. 40mins static vs 10 mins stimulation. This is my big problem - its not comparing like with like. After 40mins of sitting the subject had a certain level of pooling, after 10mins of stimulation they had ~30% of this pooling. So it begs the question, if the stimulation had been continued for a comparative 40mins would the pooling have been worse than just sitting i.e. 30% after 10 mins stimulation = 120% after 40 mins stimulation.

4. I suppose the subjects act as their own control, but perhaps the two conditions should have been randomly ordered?

5. Yes indeed, but these stats could be improved now.

Why is it not published though?

 

I've owned one of these for a few years and it often gathers dust however I was told yesterday by my vascular specialist that I had chronic venous hypertension and venous insufficiency. Sometimes it's just too painful for me to get up and have a walk. I'm committed to giving the machine a serious go because I just need something other than compression stockings (in an aussie summer) to help. In the past I've found sporadic relief but I was never persistent so I'm going to try 3 times a day for a month and see if there is improvement. I have been researching on google however to see what vascular specialists thought of the machine and came across this thread.

The thing I found completely mind boggling is this. On the Australian site there is a tv ad with good old aussie swimmer Dawn Fraser endorsing this - in a very artificial stiff way however and the most amazing thing? She says 'let's have a look at what hundreds of thousands of users are saying' - quick shot over to a man saying how much it has helped him followed by a woman. Guess what? They are the owners of the company here in Australia!!! They didn't even go get video testimonials from bona fide customers!! I have to say even if the CB does help me I don't think much of the company and their marketing.
The reason I know it's the owners is there is a press release on the australian website with a pdf of a local paper article showing the same two people!!
The other point I thought I'd mention is that it is very interesting how there is no way for customers to give feedback via social media. No facebook/twitter/blog as far as I can see. Keeping themselves safe from comment is not a very transparent look. Neither is giving bogus testimonials on a television ad!!

cheers
ng.

 

I had no idea about the ad. Thats not very good at all.

 

yes .....it's amazing!!

Here's the link to the press release
http://www.sunshinecoastdaily.com.au/story/2009/04/01/launch-give-world-boost/

Here's the tv ad...

http://www.youtube.com/watch?v=plACuxWK1Fw

the annoying thing is that comments aren't allowed on the video!!

tell me it's not the same two people!! who looks after this sort of thing I wonder? Department of Fair Trade? I need to tell someone.....

ng

 

Yes, it is embarrassing for the company. Those in the video providing the testimonial do appears to be the owners! As for it being legal or breaking any guidelines, it probably doesn't.

 

Someone is on to it:
mUmBrella is reporting:
Circulation device ad features testimonials from close to home

Full story

 

yes i see mumbrella found out about them
good to see that they've replaced the testimonials with two others in the advert.
not good behaviour....

 

Hi All

I'm webmaster for footindiabetes.org

Today I received an email from the UK owner of the company that distributes the booster. The owner asks me to remove an old scientific study for circulation booster from the FDUK forum saying the paper is out of date and copyright.

There is no copy of the study on footindiabetes.org - just a link to the Kings clinical study on the company's own website.

I can't give an opinion on the efficacy or otherwise of Circulation Booster because I can't find any solid research to guide me.

The owner also claims to have new research. I've asked to see it. If the company would post the new evidence here I'm sure it will get some attention.

 

Hi Admin

Thanks,

The link is dead now (they must have since removed the pdf) so I've taken it off anyway.

I haven't received any papers on new research yet. Just an offerr to meet up but without any proper research available to me I can't justify any time spent on it.

 

My concern is over sustained use by people with neuropathic conditions, in particuler diabetes.
The reason being, that continued vibration (eg power tools, etc) can cause nerve damage and mononeuropathy. So people who report 2-3 hrs daily use of these devices are putting themselves at risk of further nerve damage.
Any ideas on this?

 

I am new her and am not surprised by the comments. EMS has been used as a muscle stimulation. It was recommended for me for a sore upper back caused by whiplash.
Using it to attempt to mimic muscle contractions in the calf will work and it might increase blood flow out. This should cause an increase in arterial flow due to the pressure differential. However it should not work for anyone who has venous insufficiency due to weak vales in the veins. The study I read claimed the people studied were healthy subjects, implying they had good valves and normal circulation. The results would have been real but for healthy people only.

The ads I have seen are by older people none of which talk about poor circulation.

I am involved with a company which has developed a mechanical device which has been tested and is now approved for use in the USA, Canada and the EU. Due to forum restrictions I will not mention it by name, but if anyone wants to find out more they will have to email me. I know it works because my mother used one to help heal her diabetic ulcer after having lost her other leg to a similar wound. I am also on twitter

Curiously the Canadian Flag bearer , Simon Whitfield, saw someone wearing one and thought it would help him recover faster so he and some of his teammates will be using them at the Olympics.

 

http://www.google.co.uk/url?sa=t&rc...g4HwAw&usg=AFQjCNGbx1rw3CUwW-nOVB6r8OhmwcNstw

Hope this link works. I query the muscle stimulation hypothesis, thinking more along the lines of electrical stimulation promoting tissue repair.
I have heard of Mr Whitely, mutual patients speak well of him and, as for the device, my patients speak well of that too.

 

As a T1D for 53 years now i developed numbness in my feet 25 years ago. It occurred during my running after about 2 km. Later I noticed the numbing during long hikes of over 4 miles. The sensation would resolve after about 15 minutes of rest, and recur at the same distance as I resumed running or hiking. My ENDO put it down to neuropathy and suggested there was little to be done about it.

I began taking 2 500mg tablets of Vit B3 Niacinthree just over 2 years ago to help with removing arterial plaque. Much to my surprise I discovered that the numbness I had been experiencing for hiking or running had completely disappeared. The only conclusion that I can make is that the numbness, pain and tingling is because the nerves were "falling asleep" due to a lack of oxygen; the same situation people get when they cut off circulation to their arms by laying on them .

It is well know that Niacin boosts the production of HDL, which in turn reduces the LDL. It has also been cliniclly shown to reduce the thickness of arterial plaque. The niacin flush can be eliminated by taking as little as 81 mg of asperin 30 minutes before taking the Niacing. In Canada Nicin costs $ 12 for 100 x 500 mgs. It is very cheap and just as effective as more expensive patented drugs and it has no effect on the liver as do many of the prescribed drugs.

 

I have a client who claims she was electrocuted by one of these things. When i saw her he skin was erythematous was peeling from one foot and one hand on the same side.

She Claims she contacted the company and was told to send it back. She heard nothing and it apparently went missing in the post?

Hearsay i know... but what i saw could certainly have been caused by electric shock.

She also didn't get proof of postage!

 

My understanding of the tems system is that they do work to cause muscle contraction, however the compression of the calf muscle by itself will not increase circulation, especially if the patient has chronic vascular insufficiency due to non sealing valves in the veins. The company I represent < Saringer Life Sciences Technologies Ltd, became interested in developing a machine to effectively boost circulation for people who sit for hours on transoceanic flights of 6 hours . This was an attempt to prevent deep vein thrombosis. The inventor ,John Saringer, working with a world renowned vascular surgeon, Jack Hirsh, developed the small battery powered Venowave for treating a multitude of PAD situations. The device works by gently massaging the calf muscle in an upward motion forcing blood back to the heart. Even people with leaky valves benefit because the massage is continuous cycling about 12 times a minute. More information can be found on the venowave.com website or send me a direct message.

 

Circulation boosters appear to be very effective at reducing swelling from venous stasis. If you have a patient with swollen ankles caused by lack of mobility, then a circulation booster will increase the muscle pump on the veins helping to return blood to your ticker. Provided there is no venous valve dysfunction and the swelling in the ankles is not one of the myriad other things that will cause your ankles to swell there is no reason that a circulation booster won't help, in exactly the same way walking or calf exercises will reduce swelling.

Will a circulation booster help arterial circulation. Not a snowflakes chance in hell.

If you have a patient with swollen ankles and you are confident their swelling is due to immobility, sure recommend one.

 

That is exactly the point. The company has never explained how it can help the arterial circulation, when it can't - yet they keep claiming that it does.

I was at home yesterday and there was an infomercial on it during daytime TV - I could not believe the BS they still spreading (and kept a straight face!)

They still have not produced the peer reviewed scientific research they keep promising - how many yrs ago did we first start seeing those promises?

I have very little respect for a company that used legal threats against a blogger to get them to remove links to the ASA decision on their false advertising.

 

Comments on this thread have been inactive for many years now however I found this thread after a relative enquired about these devices, still on high rotation advertising on TV in Australia. I suspect that this topic is still a popular search subject and my comments to this message that mentions TENS are limited to what I perceive as potentially confusing TENS technology with EMS.

In name (M for Muscle, N for Nerve) and function these are very different; specifically in respect to both their intended target and the electrical pulse form required to stimulate that target. Note: I have not read the TENS thread in this Arena, I am not associated with any item presented for retail related to exercise or health and I hold no electrical expertise.

I am a retired Veterinarian and an undergrad when TENS devices were being introduced in the early 1970's. A Vet grad from an Australian Uni and a few years ahead of me was using TENS on high exercise dogs with spinal pain and found the ones available had one side effect in common, which was some degree of unwanted muscle stimulation from the pulses delivered. This practitioner investigated the problem and rectified the cause proceeding to manufacture a perfected unit that delivered NO muscle stimulation but only electrical pulses targeting nerve endings in the location of the electrodes designed to confound pain signals (warning: this action is my interpretation of how a TENS operates!). Yes: TENS with no unwanted muscle contractions (EMS ) only a side effect of a poor TENS unit.

Muscles (via the terminal nerves that stimulate a contraction) are very sensitive to a SINE WAVE with a frequency of 50Hz, the same frequency as the mains 240V power supply in Oz! (Read cardiac arrest here). TENS pulses need to deliver SQUARE FORM PULSES and this was the problem of poor devices - their transformers could not deliver good form square electrical pulses due to the 'slow' discharge of the metal core used in the transformer coil. If my memory is correct, the solution was to use a coil that had a low magnetic attraction core, able to generate a pulse achieving a very rapid positive voltage for the desired level and time, then a very rapid decay to zero when power is terminated. This delivers a near-perfect on/off square form pulse that does not stimulate muscle - not a square pulse with 'rounded' corners and some stimulation related to the degree of delay.

I find the later messages do provide information that indicate what conditions could benefit from EMS and what would not benefit; my perception is that any decision to try it needs to be related to the cause and degree of lower limb disease and inability to perform first-choice treatments, e.g. non-weight bearing exercises: hence it becomes a 'last resort'. Pain and the perception of pain is a broad arena and so recorded treatment outcomes will in the main be mostly personal testimonials and not come from trial based evidence.
MothyOz

 

The effect of an 8-week treatment program using a novel foot neuromuscular electrical stimulator on physical function, leg pain, leg symptoms, and leg blood flow in community-dwelling older adults: a randomized sham-controlled trial
Binoy Kumaran, Darren Targett, Tim Watson
Trials. 2022 Oct 14;23(1):873

 

Neuromuscular electrical stimulation as an adjunct to standard care in improving walking distances in intermittent claudication patients: the NESIC RCT
Laura Burgess et al
Source