Clinical Research

The Medical Research Institute of New Zealand and RBR legflow™ have published peer reviewed research papers and clinical trials (all available upon request). This research, undertaken by some of the leading clinicians specialising in Thrombosis, e-thrombosis and Deep Vein Thrombosis within sedentary workers and travellers, has been instrumental in the clinical trials, and the development of the RBR legflow™.

Air Travel

Over the last 60 years, air travel has become the predominant means by which passengers undertake long distance travel. It is estimated that more than 4.3 billion people will have traveled by plane in 2018 – a 101% increase since 2006.

With the exception of the now discontinued Concorde, there has been little change in the basic design of commercial aircraft since the widespread introduction of jet propulsion 40 years ago.

As a result, the anticipated reduction in flight times has not occurred and in fact, new technology has been utilised to develop ultra-long-distance sectors of up to 19 hours duration.  

Additionally, commercial influences have forced airlines to maximise carrying capacity by dramatically reducing the leg space available.

In 2000 the Scientific Committee of the House of Lords of the United Kingdom commissioned a report entitled Air Travel and Health”, which focused on the available literature regarding VTE following air travel.

These changes have resulted in more prolonged periods of progressively more confined seated immobility [1]

Soon after the introduction of commercial air travel, there were reports of passengers suffering lower limb thrombosis with and without pulmonary embolism.

The first published description of VTE occurring as a result of travel – now referred to as “travellers’ thrombosis” – was made by John Homans in 1954 [2].

Homans suggested that physicians should be aware of this somewhat unpredictable but serious complication of prolonged immobility.

Unfortunately 50 years later, the link between the prolonged immobility of long distance travel, desk work, gaming and increased sedentariness and Deep Vein Thrombosis remains poorly understood.

In 2006 an in-depth study was undertaken by Dr Rodney J Hughes.

During the research, it became clear that previous descriptions of “economy class syndrome” or “coach class thrombosis” were misleading and gave false reassurance to first and business class passengers.

It can – and does – affect people of all ages, from all backgrounds and is not just linked to flying but also other periods of immobility. 

A more modern phenomenon for example is the link between DVT and extended computer use [100, 101].

Subsequently, other reports have identified cases of individuals developing DVT’s during other short periods of seated immobility, such as watching a long film at the cinema [101, 102].

The conclusion of this review was that there is growing evidence of an independent association between long distance air travel and other forms of travel, as well as prolonged sitting and DVT. Although, as with other forms of DVT, the absolute risk and the role of factors unique to air travel was unclear [140].

So, what is the solution to reducing the risk of forming a DVT during a long haul flight? Flight Socks maybe? Sadly not. A paper published by the Imperial College (NHS) London in 2020, concluded that graduated compression stockings/flight socks, have no clinical or medical benefit in the prevention and/or treatment of DVT.

RBR legflow™ are now working with many international, long haul airlines to introduce the RBR legflow™ to their flights and to educate their valued customers on how to reduce any future incidents of DVT’s.


Healthcare

The cost of thrombosis to the NHS is in excess of £200 million a year.

Globally this is a cost to health service providers of more than £22 billion each year.

The most common risk factors for thrombosis are:

  • Hospitalisation for illness or surgery
  • Major surgery, particularly of the pelvis, abdomen, hip, knee
  • Severe trauma, such as a car accident
  • Injury to a vein that may have been caused by a broken bone or severe muscle injury
  • Hip or knee replacement surgery
  • Cancer and cancer treatments
  • Contraceptive pill for birth control in particular those that contain oestrogen
  • Pregnancy, (including the six weeks after the baby is born)
  • Hormone Replacement Therapy (HRT), which contains oestrogen

More than 60% of all cases of DVT are associated with hospitalisation, with many events occurring up to 90 days after admission.

DVT affects approximately one in 1000 of the UK population and is a significant cause of mortality, long-term disability and chronic ill-health problems.

Here are some more shocking facts:

  • In Europe, there are 544,000 Thrombosis-related deaths every year.
  • In the U.S. and Europe, Thrombosis-related events kill more people than AIDS, breast cancer, prostate cancer and motor vehicle crashes combined
  • In the UK, up to 60% of DVT cases occur during or after hospitalisation, making it a leading preventable cause of hospital death
  • Hospital-acquired blood clots cause an estimated 25,000 preventable deaths each year

Your Health Comes First

The RBR legflow™ is manufactured with an antimicrobial ingredient which offers excellent protection against bacteria, biofilm, fungi and mould, and has no adverse effect on the RBR Legflow™ properties.

This antimicrobial element remains effective for the lifetime of the product.

All of the active components used are approved by the FDA and EPA.

We do not use additives with potential health or environmental concerns such as Triclosan or nano-scale particles, and all of our active components have been notified for inclusion on the Biocidal Products Regulation. Using an active antimicrobial ingredient in the RBR legflow™ has enabled us to differentiate our product from those of our competitors and dramatically reduce the risk of cross-infection.

This means the RBR legflow™ is the perfect solution for the prevention, care and treatment of deep vein thrombosis and pulmonary embolism within the NHS and other health care providers globally.


Employment

Office workers who sit at a desk for eight hours a day and spend more than three hours without stretching, double their risk of developing deep vein thrombosis (DVT), according to research.

Researchers in Southampton and New Zealand questioned 200 patients who were admitted to hospital for either blood clots or heart problems and compared how long each group had remained sitting, both in total and in one period without getting up.

The study confirmed that sitting for long periods was as dangerous as flying for raising the risk of potentially fatal blood clots.

“The risk of developing blood clots with prolonged seated immobility is largely unrecognised. However, this study has shown that it is at least as important a factor as long-distance air travel” Professor Richard Beasley, Wellington Hospital (New Zealand)

The study provides preliminary evidence that prolonged seated immobility at work may represent a risk factor for venous thromboembolism (deep vein blood clot) requiring hospital admission.

Both the maximum time seated at work during a 24-hour period and the maximum time seated without getting up were associated with an increased risk of developing a blood clot.

Each additional hour spent sitting without getting up increased the likelihood of blood clots by 20%, the study found.

Almost two thirds (63%) of office workers spend six hours or more sitting at their desk. Nearly half (48%) admitted to not leaving the office all day.

Sales, media and marketing (60%) and finance (54%) emerged as the sectors with the highest percentage of people desk bound.  

Two thirds (66%) of people eat their lunch at their desk, with 90% of those in the legal profession guilty of this behaviour.

An association between prolonged periods of occupational and/or computer related sitting and developing a blood clot, was first identified in the early 2000’s [7, 9-13] and in a series of case control studies the increased risk of developing a blood clot was up to 2.4 times greater than that of the general population. [14-16]

Although the absolute risk of developing a blood clot in sedentary workers remains small, this workforce is large, and sedentary behaviours represent a potentially modifiable population-based risk factor for developing a blood clot.

Various leading corporations have made interventions to reduce sedentary activity such as stair walking campaigns, physical activity campaigns, even walking and cycling workstations have produced transient effects and are resource intensive, [17] and may negatively affect productivity, particularly with respect to computer related tasks. [18-20]

RBR leglflow™ spoke with some of the leading businesses throughout the world and there were two key messages that they were all proud to put their corporate culture firmly behind; Duty of Care and Employee Welfare.

DUTY OF CARE

A moral or legal obligation to ensure the safety or wellbeing of others. ‘Employers have a duty of care to their employees.’

EMPLOYEE WELFARE

Maintaining a healthy and safe work environment and improving staff motivation and productivity are critical issues for every workplace.

Words are wonderful – but actions make a real difference.

So what should – and could – businesses be doing to positively ensure that they are approaching their duty of care and employee welfare commitments professionally and proactively?  

By introducing the RBR legflow™ into the culture of the business, along with the proven health benefits, staff will recognise and appreciate the value that is being placed on their wellbeing. 

Not only this, but it is it is firmly believed that existing and potential clients will warm to the fact that where staff wellbeing and duty of care is taken seriously and not just an after-thought, the reputation of the organisation is enhanced. In short the adoption of the RBR legflow™ is a reflection of the positive culture at the heart of an organisation.


Gaming

Gamers as young as 12 have suffered deep vein thrombosis after hardly moving for three hours, a recent study found.

The UKIE (the Association for Interactive Entertainment) estimates that there are between 2.2 and 2.6 billion people within the global gaming audience.

Revenues for the gaming industry in 2018 reached a staggering £176 billion and it is estimated that by the year 2021 this will reach in excess of £230 billion.

Professor Richard Beasley of the Medical Research Institute of New Zealand and RBR legflow™ said there needs to be greater public and medical attention to the risks to adults and children from immobility due to the demands of leisure pursuits such as gaming.

“It really needs to be a research area of priority just as it has been with air travel which is now well recognised. People are now sitting for longer periods than they are even in long distance air travel” Professor Richard Beasley, Wellington Hospital (New Zealand)

Dr Jo Twist, chief executive of UKIE, the gaming industry’s trade body, said there was no conclusive evidence to link video games directly to DVT but added: “We encourage all games players to take regular breaks of roughly five minutes for every hour of play and there are parental controls on all consoles that can set restrictions on the amount of time spent playing games.”

The full article written by Charles Humas of the Telegraph can be read here.