Wearing Compression Stockings Research Articles

Determination of leg cross-sectional curvatures and application in pressure prediction for lower body compression garments

It has been recognized that the cross-sectional curvatures of lower extremities directly influence pressure magnitudes and distributions exerted by compression garments. In the practice of compression therapy, higher peak pressures produced by compression shells occurred at anatomic sites with smaller radius of curvatures and led to side effects and discomfort perception. An effective and operational method to determine leg curvature properties in order to predict pressure performances is desirable to improve comfort and mechanical function of compression garment. By employing three-dimensional (3D) digital anthropometry and two-dimensional (2D) digital image simulation, the curvatures and radius of curvatures of a total of 300 cross-sectional slices involving 1200 anatomic sites along the lower limbs were determined onto the ten healthy female subjects when they were and were not wearing compression stockings. Based on the determined cross-sectional characteristics, the skin pressures were calculated using the circumference-based and the radius of curvature-based Laplace’s equations, respectively, which were further validated against the experimental skin pressures measured by a PicoPress transducer. This study provided quantitative evidence in the exploration of the working mechanisms of uneven pressures produced by compression garments, and established a standardized method to determine cross-section-related curvature characteristics for pressure assessment and prediction, which will contribute to improving user compliance of compression garments in long-term wear.

Acute effect of wearing compression stockings on lower leg swelling and muscle stiffness in healthy young women.

Compression stockings are known to be effective in reducing peripheral oedema or leg swelling by increasing tissue pressure and venous blood flow. While previous studies on compression stockings have focused on its prolonged, preventive effect on leg swelling, the aim of this study was to investigate an acute effect of wearing compression stockings on lower leg swelling and muscle stiffness. Twenty healthy women aged 18-23years participated in the experiment conducted in the evening, in which they wore below-knee graduated compression stockings and rested in a seated position for 30min. Before and after the application of stockings, maximum calf circumference, volume, extracellular water resistance (RECW ) and muscle stiffness of the right lower leg were determined by tape measure, water displacement volumetry, segmental bioelectrical impedance spectroscopy and ultrasound shear-wave elastography, respectively. The maximum calf circumference and the reciprocal of RECW (an index of extracellular fluid volume) significantly decreased after the application of stockings, whereas the total lower leg volume and the stiffness (shear modulus) of the medial gastrocnemius muscle tended to decrease. These changes, except for that in the medial gastrocnemius muscle stiffness, were opposite to those from morning to evening studied in the subgroup of participants (n=8). However, partial correlation analysis failed to detect significant associations among these changes. These results suggest that even for a short period of application, compression stockings have some positive effects against lower leg swelling.

Results of catheter-directed thrombolysis for acute ilio-femoral deep venous thrombosis - A retrospective cohort study.

BackgroundCatheter-directed thrombolysis may prevent post-thrombotic syndrome in patients with ilio-femoral deep venous thrombosis. We performed a retrospective review of prospectively collected follow-up data to evaluate the results of catheter-directed thrombolysis at our institution.MethodPatients admitted for venous thrombolysis were included in the study and their files screened for information regarding results and technical aspects of treatment and patient status on follow-up. A catheter was inserted under imaging guidance into the thrombosed vein. Through the catheter tissue plasminogen activator was administered. Daily catheter-based venographies were performed to monitor progression in thrombus resolution. After thrombolysis flow-limiting stenosis was stented. Patients started wearing compression stockings and were started on oral anticoagulant therapy. Follow-up visits with ultrasound, magnetic resonance venography and clinical assessment were scheduled at six weeks and three, six, 12 and 24 months.ResultsA total of 48 patients underwent catheter-directed thrombolysis, including 36 female patients. Median age was 28 years. Complete lysis of the thrombus was achieved in 43 cases and partial lysis in two cases and 26 stents were placed. No deaths or life-threatening bleeding events occurred. Thirty-two of the patients who achieved full lysis and were followed up remained patent at follow-up. At 12 months seven patients had symptoms of post-thrombotic syndrome.ConclusionCatheter-directed thrombolysis represents a safe and effective alternative to systemic anticoagulative treatment of deep venous thrombosis with rapid resolution of the thrombus and few complications. Long-term patency shows good validity and this study suggests that catheter-directed thrombolysis is effective in preventing post-thrombotic syndrome.

Compression therapy for prevention of post-thrombotic syndrome.

Post-thrombotic syndrome (PTS) is a long-term complication of deep vein thrombosis (DVT) that is characterised by chronic pain, swelling, and skin changes in the affected limb. One of every three people with DVT will develop post-thrombotic complications within five years. Several non-pharmaceutical measures are used for prevention of post-thrombotic syndrome during the acute phase of DVT. These include elevation of the legs and compression therapy. Clinicians and guidelines differ in their assessment of the utility of compression therapy for treatment of DVT. This is an update of a review first published in 2003. To determine relative effectiveness and rate of complications when compression therapy is used in people with deep vein thrombosis (DVT) for prevention of post-thrombotic syndrome (PTS). For this update, the Cochrane Vascular Information Specialist (CIS) searched the Cochrane Vascular Specialised Register (20 March 2017) and CENTRAL (2017, Issue 2). The CIS also searched trial registries for details of ongoing or unpublished studies. We included randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of compression therapy, such as bandaging and elastic stockings, in people with clinically confirmed DVT. The primary outcome was the occurrence of PTS. Two review authors (DK and EvL) identified and assessed titles and abstracts for relevance, and a third review author (DA) verified this assessment independently. Review authors imposed no restrictions on date or language of publications. Three review authors (DA, DK, EvL) used data extraction sheets to independently extract study data. We resolved disagreements by discussion. We identified 10 RCTs with a total of 2361 participants that evaluated compression therapy. The overall methodological quality of these trials was low. We used only five studies in meta-analysis owing to differences in intervention types and lack of data. Three studies compared elastic compression stockings (pressure of 30 to 40 mmHg at the ankle) versus no intervention. Two studies compared elastic compression stockings (pressure 20 to 40 mmHg) versus placebo stockings. Overall, use of elastic compression stockings led to a clinically significant reduction in the incidence of PTS (risk ratio (RR) 0.62, 95% confidence interval (CI) 0.38 to 1.01; P = 0.05; 1393 participants; 5 studies; low-quality evidence); no reduction in the incidence of severe PTS (RR 0.78, 95% CI 0.53 to 1.15; P = 0.21; 1224 participants; 4 studies; low-quality evidence); and no clear difference in DVT recurrence (RR 0.94, 95% CI 0.69 to 1.28; 1212 participants; 4 studies; P = 0.69; low-quality evidence). We did not pool data on the incidence of pulmonary embolism because this information was poorly reported, but we observed no differences between groups included in individual studies (low-quality evidence).Two studies evaluated effects of compression in the acute phase versus no compression treatment and found no differences in the incidence of PTS (RR 0.76, 95% CI 0.49 to 1.16; P = 0.2; 101 participants). One study reported that thigh-length stockings did not provide better protection against development of PTS than knee-length stockings (RR 0.92, 95% CI 0.66 to 1.28; P = 0.6; 267 participants). Another trial reported that wearing compression stockings for two years seemed to be superior to wearing them for one year in terms of PTS incidence.Two of the 10 included studies described patient satisfaction and quality of life (moderate-quality evidence), using different measurement systems. The first study showed significant improvement in well-being and DVT-related quality of life with compression treatment (P < 0.05) compared with bed rest, and the second study showed no differences in quality of life scores between compression and placebo groups. Four studies poorly reported side effects (low-quality evidence) that included itching, erythema, and other forms of allergic reaction and described no serious adverse events. Compliance with wearing of compression stockings was generally high but varied across studies. Low-quality evidence suggests that elastic compression stockings may reduce the occurrence of PTS after DVT. We downgraded the quality of evidence owing to considerable heterogeneity between studies and lack of or unclear risk of blinding due to clinical assessment scores. No serious adverse effects occurred in these studies. Large randomised controlled trials are needed to confirm these findings because of current lack of high-quality evidence and considerable heterogeneity.

Factors of compliance with the wearing of elastic compression stockings in a Sub-Saharan population

Elastic venous compression is the basic treatment of chronic venous insufficiency (CVI) and deep vein thrombosis (DVT). Very little data exist in sub-Saharan Africa concerning the wearing of compression stockings. To determine the factors of compliance with wearing elastic compression stockings. This retrospective cross-sectional descriptive and analytical study involved 200 consecutive patients (93 cases of DVT, 94 cases of CVI, 13 cases of DVT and CVI). Data on compliance with wearing compression stockings and the factors influencing this compliance were collected. The average age was 51±15 years old (range 17 and 91 years old). The sex ratio was 1. The majority of patients (78.5%) performed their occupation in a standing position, for more than 8hours per day for 80.5%. DVT were preferentially on the left side (52.9%) and proximal (44.4%). Concerning the CVI, the predominant symptoms were class C3 (52.3%), C4 and C5 (43.9%) of the CEAP classification. Bilateral involvement was dominant (53.3%) and the large saphenous vein was the most affected (66.9%) compared with 33.1% for the small saphenous vein exclusively. The most common type of stockings prescribed was the lower mid-thighs (57%), followed by the pantyhose (30%), in classes 3 (63%) and 2 (36.5%). The majority of patients (75%) agreed to wear their stockings after prescription with a good compliance rate of 58.5% at the beginning of the prescription. At the time of the study, this rate was 11%. The optimal duration of compliance with wearing compression stockings was 6 months (64%). Over 12 months this rate fell to 7.5%. The main causes were stocking-related compression discomfort (36.7%), patient neglect (21.5%), threading difficulties (16.9%), and an unfavorable working environment (8.7%). The determining factors of compliance with wearing of stockings were living in a couple (68.4% vs 54.2, P=0.04), CVI (53% vs 38.2%, P=0.04) and C3 (39% vs 80%), C4 (37.5% vs 17%), C5 (18% vs 3%) CVI (P=0.0005). Compliance with wearing elastic compression stockings is mediocre. The main factors of non-compliance are discomfort, threading difficulties and patient neglect.

Role of conservative treatment of chronic venous insufficiency for regression of the features of desadaptive cardiac remodeling in patients with comorbid obesity

Aim. To evaluate the influence of conservative treatment tactics for chronic venous insufficiency on the processes of cardiac remodeling in patients with comorbid obesity. &#x0D; Methods. 32 males with obesity class 1 (BMI 32.57±2.25 kg/m2) at the age of 40.7±11.5 years and with clinical and instrumental signs of chronic venous insufficiency were divided into 2 groups: patients from group 1 (n=14) followed the recomendations to wear compression stockings and to use hesperidin + diosmin 500 mg twice a day, and the patients from group 2 (n=18) did not follow those recommendations. All patients had echocardiography performed before the treatment and 2 months after the first visit. For the evaluation of echocardiographic dynamics paired Student’s t-test was used. &#x0D; Results. After 2 months statistically significant dynamics of the following echocardiographic findings was revealed: in group 1 index of eccentric left ventricular shape increased from 0.94±0.06 to 1.01±0.03, in group 2 - from 0.96±0.08 to 0.97±0.07 (р=0.023). In group 1 tricuspid annular plane systolic excursion decreased from 30.07±5.31 to 26.64±4.14 mm, in group 2 - from 29.6±4.72 to 29.88±6.04 mm (р=0.008), and the right atrial volume in group 1 decreased from 53.57±11.48 to 46.64±13.18 ml, in group 2 - from 52.77±11.27 to 51.38±8.54 ml (р=0.044). In group 1 statistically significant trend to decreased ratio of maximal velocity of RV early diastolic filling to maximum diastolic tricuspid valve lateral annular velocity was revealed (from 4.75±1.35 to 4.25±1.23 cm/sec) compared to group 2 (from 4.79±1.62 to 4.75±1.58 cm/sec; р=0.076). &#x0D; Conclusion. Conservative treatment of chronic venous insufficiency in patients with obesity is associated with indirect indicators of decreasing volume overload of the heart and can influence positively on heart geometry leading to regression of spheric LV remodeling and decrease of RA volume.

Relationship between patient-reported symptoms, limitations in daily activities, and psychological impact in varicose veins.

The objective of this study was to evaluate the relationship between patient-reported symptoms, functional limitations, and psychological impact of varicose veins (VVs) vs pathophysiologic mechanism, incorporating demographic and behavioral factors. We conducted a pooled analysis from two clinical studies (Efficacy and Safety Study of Polidocanol Injectable Foam for the Treatment of Saphenofemoral Junction Incompetence [VANISH-1] and Polidocanol Endovenous Microfoam Versus Vehicle for the Treatment of Saphenofemoral Junction Incompetence [VANISH-2]) in patients with VVs (superficial venous reflux only). Health outcomes were classified on the basis of the Wilson-Cleary conceptual framework continuum linking clinical and anatomic factors (Clinical, Etiology, Anatomy, and Pathophysiology [CEAP] clinical class and great saphenous vein [GSV] diameter, respectively) to patient-reported outcomes: Varicose Vein Symptoms Questionnaire (VVSymQ) score; modified Venous Insufficiency Epidemiologic and Economic Study on Quality of Life/Symptoms (m-VEINES-QOL/Sym) limitations in daily activities (functional limitations hereafter) score; and m-VEINES-QOL/Sym psychological impact score. Association of clinical and anatomic categories with each of the patient-reported outcomes was assessed using analysis of variance for statistical significance and standardized mean differences for clinical meaningfulness. Hierarchical regression modeling was applied to evaluate the direct association of the VVSymQ symptom score with the m-VEINES-QOL/Sym functional limitations score and the indirect association with the m-VEINES-QOL/Sym psychological impact score, adjusting for clinical, behavioral, and demographic factors. Among 516 patients, approximately three-fourths were women (mean age, 49 years), approximately 70% were overweight or obese, 42% were C2 and 32% were C3, and 88% reported never or only intermittently wearing compression stockings. VVSymQ (symptom) scores did not vary by GSV diameter but were significantly worse for those with severe disease stage, especially C5 or C6. Among m-VEINES-QOL/Sym work-related function items, 47% of patients reported difficulty at work and 31% reported cutting down at work. On nonwork function items, standing for prolonged periods was most affected; 53% were limited a little and 22% were limited a lot. Concern about appearance and choice of clothing predominated among psychological impact items, with 74% and 65%, respectively, affected all or most of the time. The m-VEINES-QOL/Sym functional limitation and psychological impact scores varied by neither GSV diameter nor CEAP C class, but they varied directly with VVSymQ (symptom) score quartiles. Multivariable regression analysis revealed that VVSymQ symptom scores continued to be associated with m-VEINES-QOL/Sym psychological impact scores, even after adjustment for m-VEINES-QOL/Sym functional limitation scores. Substantial patient-reported functional limitation and psychological impact of VVs were observed. Limitations on work, standing for prolonged periods, concern about appearance, and clothing choice were most affected. Patient-reported VVSymQ (symptom) score, an objective patient-reported measure of symptom severity in VVs, was the key predictor of patient-reported m-VEINES-QOL/Sym functional limitations. Symptoms and functional limitations led to greater psychological impact. Physicians should routinely ascertain symptoms and functional limitations to enhance quality of care and to document medical necessity.

A randomized crossover trial on the effect of compression stockings on nausea and vomiting in early pregnancy.

IntroductionThis study aimed to assess the impact of wearing compression stockings on women’s quality of life (QoL) associated with nausea and vomiting in early pregnancy (NVP).MethodsIn this randomized, open, single-center, crossover study, 74 women were assigned 1:1 to 2 weeks with compression stockings followed by 2 weeks without or vice versa. The main outcomes were NVP-associated QoL, leg-related QoL, and dizziness, as assessed by the Nausea and Vomiting in Pregnancy Quality of Life (NVPQOL) questionnaire, Chronic Venous Disease Quality of Life (CIVIQ) questionnaire, and questions on dizziness at baseline and after each 2-week period, respectively. Daily NVP was assessed using the modified Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) questionnaire. Data were analyzed using Pearson’s chi-square and independent t-tests.ResultsFifty-eight women completed the study. QoL scores improved with compression treatment; changes in mean total scores were as follows: NVPQOL, −36.7 with compression vs −21.7 without (P<0.0001); and CIVIQ, −4.5 with compression vs +1.4 without (P=0.001). Mean dizziness scores were −3.2 with compression vs −0.4 without (P<0.0001). PUQE mean total score (standard deviation) was 4.9 (2.3) with compression vs 5.5 (2.2) without (P=0.042).DiscussionWearing of compression stockings in early pregnancy may improve nausea and vomiting-associated symptoms in addition to improving QoL factors.

Direct correlation between compression stockings and venotonics (Diosmins) and flow vein diseases in stomatology students

Diseases of veins are considered one of the most common diseases of modern man, right after caries of teeth. Those diseases usually come to exist as a result of genetic and/or other pre-dispositioning factors, however, in most cases, those factors can be effectively tamed through preventive and therapeutic methods. Two studies were carried out on randomly selected third and fourth year stomatology college students. In the first study, we solely focused on the effects of monotherapy compression stockings. The second study was a continuation of the first and the respondents were asked to take venotonic Diosmin (Detralex 1000 mg) in addition to wearing compression stockings. In the group of 30 patients, 49% had positive family history of the disease, and in total, 70% showed signs of discomfort and diseases related to venous system. Ten respondents who showed major problems or pathological changes, were given custom made Sigvaris graduated compression stockings, which they wore for eight weeks. Final results of the first study showed that the feeling of heaviness in the legs reduced in 55.55% of respondents, while 66.66% patients recorded reduced pain in legs when standing for a long time. Issues of swelling of the bottom of the feet and lower legs disappeared for all patients. In the second study, which included adding a dose of Diosmin in addition to compression stockings, 66.66% of the patients saw signs of heaviness feeling in the legs improve, 77.77% recorded that pain in the legs when standing for a long time decreased and 100% of patients saw swelling of the bottom of the feet and lower legs disappear. This eight week study was too short to show significant signs of improvement in varicose, however, we expect that in six months, patients will begin to show signs of improvement in varicose altered veins. When comparing the results of the first and second study, we concluded that the three-month combination therapy of compression stockings and Diosmin yielded 12.5% better results of reduction of the following symptoms: feeling of heaviness in the legs, pain in the legs when standing for a long time, then when just using the compression socks (study 1).

Prospective randomized controlled study of patient compliance in using a compression stocking: Importance of recommendations of the practitioner as a factor for better compliance.

Background Patient compliance is the cornerstone of compression therapy success. However, there has been up to now no tool to assess it other than self-reporting by the patient, which is not reliable. Material and methods Forty active females classified C2S were enrolled to wear compression stockings (CS) providing a pressure of 15-20 mmHg at the ankle. A thermal probe was inserted in the stocking (Thermotrack®), recording the skin temperature every 20 min for four weeks. The patients were randomized in two groups of 20: - Group 1: Receiving minimal recommendations by their physician at the office. - Group 2: Receiving in-depth recommendations by the physician reinforced with SMS message which were repeated once a week for four weeks. The basic CEAP classification and the quality of life (QoL) were recorded before and after four weeks. Results The two groups are similar for age, symptoms and type of CS. The analysis of the thermal curves showed a significant increase (+33%) in the average wearing time daily in the group 2: 8 h vs. 5.6 h (group1) p < 0.01. The average number of days worn per week is also increased: 3.4 (group 1) vs. 4.8 (group 2), thus improving patient compliance from 48.5% to 70% as a direct result of the physician recommendations ( p < 0.001). Conclusion This is the first study assessing the real compliance in CVD patients of using compression. It shows that better and repeated recommendations by the practitioner result in an increase in time the compression is used by 33%. The study also suggests that the number of days the compression stocking is worn is a good criterion of patient compliance.

Effects of compression stockings on ankle muscle H-reflexes during standing.

Wearing compression stockings (CS) may improve postural stability through additional cutaneous feedback. The aim of this study was to further determine how wearing CS could influence spinal excitability by investigating ankle muscle H-reflexes. Fifteen subjects were asked to stand barefoot on a rigid floor with their eyes open. H-reflex amplitude was measured in the soleus (SOL), fibularis longus (FL), and tibialis anterior (TA) muscles, with and without CS. Concomitant M-waves and baseline electromyographic activity (EMG) were monitored. Baseline EMG activity and concomitant M-wave amplitude remained stable across conditions in all tested muscles. Although CS did not affect the H-reflex in the SOL (+0.8 ± 19.2%; P = 0.77) and FL (-10.0± 33.2%; P = 0.28) muscles, the TA H-reflex was significantly depressed (-21.9% ± 24.0%; P = 0.03). These results suggest decreased spinal motoneuron excitability and/or increased presynaptic inhibition of Ia-afferent terminals through increased cutaneous inputs provided by CS while standing. Muscle Nerve 55: 596-598, 2017.

Compression stockings for preventing deep vein thrombosis in airline passengers.

Air travel might increase the risk of deep vein thrombosis (DVT). It has been suggested that wearing compression stockings might reduce this risk. This is an update of the review first published in 2006. To assess the effects of wearing compression stockings versus not wearing them for preventing DVT in people travelling on flights lasting at least four hours. For this update the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (10 February 2016). In addition, the CIS searched the Cochrane Register of Studies (CENTRAL (2016, Issue 1)). Randomised trials of compression stockings versus no stockings in passengers on flights lasting at least four hours. Trials in which passengers wore a stocking on one leg but not the other, or those comparing stockings and another intervention were also eligible. Two review authors independently selected trials for inclusion and extracted data. We sought additional information from trialists where necessary. One new study that fulfilled the inclusion criteria was identified for this update. Eleven randomised trials (n = 2906) were included in this review: nine (n = 2821) compared wearing graduated compression stockings on both legs versus not wearing them; one trial (n = 50) compared wearing graduated compression tights versus not wearing them; and one trial (n = 35) compared wearing a graduated compression stocking on one leg for the outbound flight and on the other leg on the return flight. Eight trials included people judged to be at low or medium risk of developing DVT (n = 1598) and two included high-risk participants (n = 1273). All flights had a duration of more than five hours.Fifty of 2637 participants with follow-up data available in the trials of wearing compression stockings on both legs had a symptomless DVT; three wore stockings, 47 did not (odds ratio (OR) 0.10, 95% confidence interval (CI) 0.04 to 0.25, P < 0.001; high-quality evidence). There were no symptomless DVTs in three trials. Sixteen of 1804 people developed superficial vein thrombosis, four wore stockings, 12 did not (OR 0.45, 95% CI 0.18 to 1.13, P = 0.09; moderate-quality evidence). No deaths, pulmonary emboli or symptomatic DVTs were reported. Wearing stockings had a significant impact in reducing oedema (mean difference (MD) -4.72, 95% CI -4.91 to -4.52; based on six trials; low-quality evidence). A further two trials showed reduced oedema in the stockings group but could not be included in the meta-analysis as they used different methods to measure oedema. No significant adverse effects were reported. There is high-quality evidence that airline passengers similar to those in this review can expect a substantial reduction in the incidence of symptomless DVT and low-quality evidence that leg oedema is reduced if they wear compression stockings. Quality was limited by the way that oedema was measured. There is moderate-quality evidence that superficial vein thrombosis may be reduced if passengers wear compression stockings. We cannot assess the effect of wearing stockings on death, pulmonary embolism or symptomatic DVT because no such events occurred in these trials. Randomised trials to assess these outcomes would need to include a very large number of people.

Compression and sports

Not available

Trophic application in CVI I with peripheral oedema compared with compression stockings

Summary Aim In the warm season of 2015, the efficacy of Allga Med® Antiswelling Foot Spray and Allga Med® Warm Feet Balsam in combination with a class 2 compression stocking was compared with the efficacy of a compression stocking of the same class applied alone. Method 40 women aged 23–78 years (mean 48 years) were included in the investigation. The women were all overweight (mean height: 166 cm, mean weight: 83 kg; mean BMI 30.1 kg/m2). For one month before their inclusion, they had not been permitted to take venous medication or wear compression stockings. Prior to the start of the study, class 2 compression stockings were prescribed. The compression stockings were worn consistently during the day for 14 days. In addition, the right leg was treated twice daily with foot spray and balsam. Before the start of the study and after 14 days, the foot and distal lower leg volume of both legs was measured by means of water plethysmography Result On the stockinged left leg, the volume decreased by 152 ml. On the right leg, which was trophically treated and stockinged, the volume decreased by up to 335 ml.

The Effect of Graduated Compression Garments on Foot Volume During Running

Compression stockings are commonly recommended to help reduce edema in the lower extremities at rest; however, the effect of wearing compression stockings on lower extremity edema during exercise remains a mystery. Understanding the effects of compression stockings on foot volume during exercise could potentially increase the type of aerobic activities available to adults with conditions contributing to lower extremity edema. PURPOSE: To determine if compression stockings will reduce running associated increases in foot volume compared to running without compression stockings. METHODOLOGY: Ten recreational runners (8 male, 2 female; 27.3±5.8 yrs; 73.2±8.4 kg, VO2max 49.1±5.9 ml/kg/min) completed two 20 min submaximal treadmill runs (1% grade, 11.2±1.1 km/hr, 72.3±2.9% of VO2max) with a compression sock or sleeve on the dominant leg and a regular sock on the control leg. Compression and control foot volume was measured using a foot volumeter before and after each trial and compared using a repeated-measures ANOVA. Pre and post run volume comparisons within groups were performed using a paired t-test (α=0.05). RESULTS: In response to 20 min of treadmill running, foot volume significantly increased (p<0.05) in the control leg of the sock and sleeve trials (4.2±2.4 and 6.0±4.9%), as well as in the sleeve leg (3.1±3.5%). There was a non-significant trend for an increase in the sock leg (1.8±3.1%; p=0.08). The overall increase in foot volume was greater (p<0.05) in the control leg compared to the sock (24±14.1 to 11±17.8ml) and sleeve (33.0±27.5 to 17.5±20.8ml) legs, respectively. There was no difference in foot volume when comparing the effects of the compression sock to the sleeve. CONCLUSION: Use of a compression sock or sleeve appears to reduce the observed increase in foot volume experienced among runners, and this effect may be greater with a compression sock than sleeve.

Efficacy of compression stockings in preventing post-thrombotic syndrome in patients with deep venous thrombosis: a systematic review and metaanalysis.

Here, we update an earlier systematic review on the preventive efficacy of active compression stockings in patients with diagnosed proximal deep venous thrombosis (DVT) by including the results of recently published trials. The aims are to synthesize the results of the original studies, and to identify details to explain heterogeneous results. We searched the Cochrane Library, PubMed, Scopus, and Medline for original studies that compared the preventive efficacy of active compression stockings with placebo or no compression stockings in patients with diagnosed proximal DVT. Only randomized controlled trials (RCTs) were included. Five eligible RCTs with a total of 1393 patients (sample sizes ranged from 47 to 803 patients) were included. In three RCTs, patients started to wear compression stockings, placebo stockings or no stockings within the first three weeks after the diagnosis of DVT. The results of two RCTs indicate a statistically significant reduction in post-thrombotic syndrome (PTS) of 50% or more after two or more years. The result of one RCT shows no preventive effect of compression stockings at all. Due to the heterogeneity of the study results, we refrained from pooling the results of the RCTs. In a further RCT, randomization to groups with and without compression stockings took place six months after the diagnosis of DVT, and in another RCT, only patients with the absence of PTS one year after the diagnosis of DVT were analyzed. One RCT revealed a significant reduction in symptoms, whereas another RCT failed to show any benefit of using compression stockings. At this time, it does not seem to be justifiable to entirely abandon the recommendations regarding compression stockings to prevent PTS in patients with DVT. There is evidence favoring compression stockings, but there is also evidence showing no benefit of compression stockings.

Effects of Wearing Compression Stockings on the Physical Performance of T2DM Men with MetS.

Metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) are associated with macro- and microcirculatory complications that reduce physical performance. Wearing compression garments to potentially optimize hemodynamics has been discussed. This study investigates the effects of wearing compression stockings on physical performance-related variables in type 2 diabetic men with metabolic syndrome (n=9, 57±12 years, BMI: 36±4 kg/m(2)). Participants served as their own controls in a randomized 3*3 crossover study wearing below-knee stockings with either compression (24 or 30 mmHg ankle pressure) or no compression. Venous pooling and lower limb oxygenation profiles were determined with near-infrared spectroscopy and arterial oxygen saturation was determined using a pulse oxymeter. Measurements were performed in the supine lying position, during standing, following 10 tiptoe exercises and after submaximal intensity cycling. In addition, lactate and erythrocyte deformability were analyzed in capillary blood pre- and post-exercise. Erythrocyte deformability was analyzed using a laser-assisted optical rotational red cell analyzer. No significant differences in any variables when wearing different compression or regular stockings were evident at any point of measurement. This study did not reveal any beneficial effects of wearing compression stockings at rest and during acute bouts of moderately intense exercise in this particular patient group.

The Effect of Compression Stockings on Cerebral Desaturation Events in Obese Patients Undergoing Shoulder Arthroscopy in the Beach-Chair Position

To determine if the use of thigh-high compression stockings could decrease the incidence of cerebral desaturation events (CDEs) in patients with a body mass index (BMI) of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the beach-chair position (BCP). Between December 2013 and May 2014, 23 patients aged 18 years or older with a BMI of 30 kg/m(2) or greater undergoing shoulder arthroscopy in the BCP were monitored intraoperatively using near-infrared spectroscopy while wearing thigh-high compression stockings. Data obtained on these patients were compared with data from a previous cohort at our institution comprising 24 patients with a BMI of 30 kg/m(2) or greater who underwent elective shoulder arthroscopy in the BCP with the same monitoring but without wearing compression stockings. The incidence of CDEs was identified in each group. The incidence of CDEs in the group with compression stockings was 4% (1 of 23) compared with 18% (7 of 24) in the group without compression stockings (P= .048). There were no statistically significant differences in mean age (53.0 years v 53.3 years, P= .91), mean BMI (34.5 kg/m(2)v 36.2 kg/m(2), P= .21), or various medical comorbidities between the treatment group and control group. There was a significant difference in the operative time between the treatment group (156.6 minutes) and control group (94.1 minutes) (P < .001). The use of thigh-high compression stockings may decrease the incidence of CDEs in obese patients undergoing shoulder arthroscopy in the BCP. Level IV, therapeutic case series.

The use of compression stockings during a marathon competition to reduce exercise-induced muscle damage: are they really useful?

Case-control study; ecological study. To examine the efficacy of wearing compression stockings to prevent muscle damage and to maintain running performance during a marathon competition. Exercise-induced muscle damage has been identified as one of the main causes of the progressive decrease in running and muscular performance found during marathon races. Thirty-four experienced runners were pair-matched for age, anthropometric data, and best race time in the marathon, and randomly assigned to a control group (n = 17) of runners who wore conventional socks or to a group of runners who wore foot-to-knee graduated compression stockings (n = 17). Before and after the race, a sample of venous blood was obtained, and jump height and leg muscle power were measured during a countermovement jump. Serum myoglobin and creatine kinase concentrations were determined as blood markers of muscle fiber damage. Total race time was not different between the control group and the compression stockings group (210 ± 23 and 214 ± 22 minutes, respectively; P = .58). Between the control group and the compression stockings group, postrace reductions in leg muscle power (-19.8% ± 17.7% versus -24.8% ± 18.4%, respectively; P = .37) and jump height (-25.3% ± 14.1% versus -32.5% . 20.4%, respectively; P = .27) were similar. At the end of the race, there were no differences between the control group and the compression stockings group in serum myoglobin (568 ± 347 ng·mL(-1) versus 573 ± 270 ng·mL(-1), respectively; P = .97) and creatine kinase concentration (390 ± 166 U·L(-1) versus 487 ± 227 U·L(-1), respectively; P = .16). The use of compression stockings did not improve running pace and did not prevent exercise-induced muscle damage during the marathon. Wearing compression stockings during long-distance running events is an ineffective strategy to avoid the deleterious effects of muscle damage on running performance. Therapy, level 2b.

他動的足関節運動中の弾性ストッキングの圧迫圧と筋酸素化状態の測定

Purpose: The purpose of this study was to simultaneously measure time course changes in pressure of compression stocking and oxygenation state of the gastrocnemius muscle (MG) during passive dorsiflexion in patients who admitted to the ICU after surgery. Methods: Participants comprised five patients in post-surgical state of esophageal cancer (mean age, 59.4±6.1 years). Patients were performed exercise consisted of 10 cycles involving passive dorsiflexion and release until a few hours after surgery. Changes in oxygenated hemoglobin (oxy-Hb), deoxygenated hemoglobin (deoxy-Hb) and total hemoglobin (t-Hb) of medial belly of the MG were measured by near infrared spectroscopy. Changes in pressure of compression stocking was simultaneously measured at the lateral side of the MG. Results: The compression pressure was 20.4±1.6 mmHg at rest and increased up to 4.2±3.2 mmHg during dorsiflexion. oxy-, deoxy-, and t-Hb decreased during dorsiflexion, and recovered during release. t-Hb after 5-min passive exercise significantly decreased as compared with those before exercise. Conclusions: Increase in compression pressure during dorsiflexion may induced by changes in shape of calf. Passive exercise for 5 min might decrease muscle blood volume in patients while wearing compression stockings studies.