The need of carrying on this physio-pathologic, diagnostic and therapeutic in depth study derives from the remark that these diseases are more and more noticed in western and industrialized countries' people. 

*About  9 millions of  Italians, 2/3 women and 1/3 men,  are affected by evident venous insufficiency. On setting venous insufficiency affects about the half of the whole Italian population, about 25 millions of Italians, while swelling originated by lymphatic causes affects about 1/3 of the whole Italian population.  

The venous and lymphatic insufficiency is, therefore, to be considered as a real social disease.

The biological evolution of the human being led him to a biped erect posture, with consequences acting on his venous and lymphatic systems. 

*The body has, then, developed a system of impulse giving and aspirating pumps, that facilitates the venous and lymphatic return along the legs. This system is made up of constricted communicating vessels, able to function even in the new anti gravitational posture. 

*The gait cycle actives the plantar pump and its structures.  As you can notice it is a highly complex and delicate system, where each component has to preserve the integrity of its function, rising from the elasticity and the modification of the plantar arches, to the normal  and uniform distribution of the fasciae's fibro elasticity, to the normal spatial arrangement of the joints, till the normal and uniform  distribution of the tone and the muscles' contracting function.

*Dr. Fusco,  one of the leader of the modern posturology in Italy,  studied into particular depth the postural disorders caused by a wrong functioning of the sole of the foot. 

*Her theory moved from considering that the preservation of the normal curvature of the arches of the foot, even in standing patients,  when the feet are loaded by the body's weight and by the atmospheric pressure, is due to the triggering of an active anti gravitational force. This force is triggered by the muscular and fasciae's tissue. Dr. Fusco singled out the intrinsic muscles of the sole of the foot, which are responsible of keeping the normal shape of the arches of the foot in orthostatics. 

*She named these structures " static chain of the sole off the foot". This chain is made up of: 

a-flexor hallucis brevis/ flexor hallucis brevis/ abbuctor hallucis/ flexor digiti minimi brevis pedis-

            responsible to maintain the anterior transverse arch  

b-flexor hallucis brevis/ abductor hallucis/ medial wedge-

            responsible to maintain the medial longitudinal arch

c-flexor digiti minimi brevis pedis/ abductor digiti minimi pedis/lateral wedge-

            responsible to maintain the lateral longitudinal arch.

*The whole fasciae's tissue contributes to this function: plantar aponeurosis, articular capsules and the whole Achilles and calcaneal system.  As you can notice the above mentioned structures are the same of the plantar pump.

*The foot is therefore an important part of our body. It is no more to be considered only as a base for standing on, but also a nervous and vascular receptor. 

*The foot can achieve its functions, only if its structures and its arches are elastic and capable of modifying their shape while walking. The foot functions as: 

1)postural receptor: it collects the information from cutaneous exteroceptors, from muscular, tendineous  and articular proprioceptors and transmits inputs to the central nervous system;

2) as vascular pump, because it gives the first flowing speed impulse to the venous blood to set off and allow the flowing on of the blood towards the hearth.  

The plantar pump is the only impulse giving and aspirating pump of the lower limb and thanks to this action, it allows the blood to arrive both to the the deep and to the superficial venous system; furthermore it is the only structure of our body capable of modifying, during the gait cycle,  its structure at the same time on the three spatial dimensions. This is achieved through highly complex actions of articular biomechanics.

*The diagnostic approach devised by Dr. Fusco is based on identifying the muscles of the static chain of the sole of the foot, which are in hypotone.  To achieve this diagnosis she uses the KS dynamometer, which measures the muscular work expressed under the formula displacement multiplied by resistance.  Applying a fixed resistance to the different muscles, the shortest displacement will allow to identify the hypotonic muscle. The graphical output of the results of the test is called "functional mapping" of the sole of the foot. 

*In order to evaluate the postural alterations Dr. Fusco performs a 3D study of the pelvis and the vertebral column with a Formetric apparatus, capable of measuring the torsion's degrees of the different body's segments and even of each vertebra.

*To achieve her diagnosis Dr. Fusco also uses a stabilometric rug, but only by static tests. 

*To treat the hypotonic muscles of the sole of the foot, Dr. Fusco devised  extero and proprioceptive neuro-bio-meachnic acting orthotics, capable of exerting a fibro elastic stimulation of the hypotonic muscles only, and of restore both the normal muscular tone and the receptive information coming from it. 

*The second case is a  72 years old female patient with a superficial venous insufficiency and varicose venous ulcers at the level of the medial melleolus on both sides. After one month treatment by stimulating the sole of the foot  is possible to notice both  an improvement of the postural arrangement  of the whole body and a plain improvement of the superficial venous circle.

*We performed also flowmetric tests with the “filtrass angio Report by Domed” apparatus.

A first experimental trial has been performed during the 14th world Congress of Phlebology, which took place in Rome in September 2001. The first graphical specimen shows a 57 years old patient with an insufficiency of the superficial venous circle on the left leg. He presents a depressed flowmetry on the left leg, 12.2,  while on the right he presents a flowmetry within the lower standard limits 19.8.

The second experimental specimen shows the results a flowmetry performed on a patient, who had previously walked one minute long on a moving carpet wearing foot's sole stimulating orthotics. Note the improvement of the value both of the flowmetry of the left leg (18.1) and of the right leg (34.6). 

The third experimental specimen shows the results a flowmetry performed on a patient, who had previously walked one minute long on a moving carpet wearing elastic stocking. Note the improvement of the value of the flowmetry compared with the value of the first examination, but note that the improvement is lower than the one obtained by the examination performed with the orthotics. The recorded values are: 14.2 for the left leg and 39.2 for the right leg.

The last experimental specimen shows the results of a combined treatment of plantar stimulation and of elastic compression. Note a plain normalization of  both the left (23.2) and right (39.0) flowmetric values.

*The second experimental trial was carried out at the University of Siena at the department of professor Mancini, in cooperation with Dr. Botta and Dr. Berna. 

The first slide shows the case of a 48 year old female patient.  She had a light insufficiency of the superficial venous circle without insufficiency of the saphena-femoral veins cross. She complained about symptoms of heaviness in the legs and during the night occurring cramps. At an objective examination it was possible to notice mild insufficiency of the superficial circle on both legs, caused by dilated small capillaries.

At the flowmetric examination performed with the “filtrass angio Report “ by  Domed she presented normal values: 28.7 on the left leg and  66.7on the right leg.

After walking by wearing the KS medical orthotics activated in order to stimulate some specific points on the sole of the foot, the female patient presented a plain improvement of the flowmetry of both legs: 68.9 on the left leg and 77.3 on the right leg. 

The third examination was performed just 30 minutes after the second one, without orthotics and while the patient was sitting. The flowmetry shows a long lasting effect of the improvement: 59.3 on the left leg and 51.6 on the right leg. 

* The second case was a 59 years old male patient with thrombophlebitis on the left leg, which was swollen, and with lymphatic insufficiency on the right leg. He regularly wore elastic stockings. The flowmetric test was performed without elastic stockings.  At the flowmetric examination he presented reduced values concerning both legs, 13.7 on the left leg and 9.9 on the right leg. Note that the circumference of the left leg was 406 mm., while the one of the right leg was 413 mm.

After walking by wearing the KS medical orthotics activated in order to stimulate some specific points on the sole of the foot, the patient experienced a plain improvement of the flowmetry on both legs: 24.8 on the left leg and 28.1 on the right leg, the legs circumference was down to 326 mm. for the left leg and to 415 mm for the right leg.