An investigation to assess ankle mobility in healthy individuals from the application of multi‐component compression bandages and compression hosiery

Abstract

BackgroundAn investigation was undertaken to compare the effect of multi-component compression bandages and compression hosiery kits on individuals’ range of ankle motion whilst wearing typical and medical footwear, and barefoot.MethodsA convenience sample of 30 healthy individuals recruited from the staff and student population at the University of Huddersfield, UK. Plantarflexion/dorsiflexion range of ankle motion (ROAM) was measured in participants over 6 steps in every combination of typical, medical and no footwear; and multi-component bandages, compression hosiery and no garments.ResultsControlling for age, gender and garments, the use of typical footwear was associated with a mean increase in ROAM of 2.54° at best estimate compared with barefoot; the use of medical footwear was associated with a mean decrease in ROAM of 1.12° at best estimate compared with barefoot. Controlling for age, gender and footwear, the use of bandaging was associated with a mean decrease in ROAM of 2.51° at best estimate compared with no garments. Controlling for age, gender and footwear, the use of hosiery was not associated with a significant change in ROAM compared with no garments.ConclusionsBandages appear to restrict ROAM more than hosiery when used in conjunction with a variety of footwear types.Electronic supplementary materialThe online version of this article (doi:10.1186/s13047-016-0151-8) contains supplementary material, which is available to authorized users.

Current and advanced therapies for chronic wound infection

“…whether necrotic or sloughy) will determine whether debridement is required. Factors such as bioburden, wound edges and the condition of peri-wound skin can also influence whether debridement is required [48]. A range of techniques can be used, dependent on the clinician's ability level: these include autolytic, larval, mechanical, sharp and surgical methods [49,50].…”

Patients at risk of the progression of chronic venous disease.

“…48 Reduced ROAM and/or CMP function can result in an increased AVP leading to oedema, skin changes, and a VLU through the path of the microcirculation without a positive diagnosis on a duplex ultrasound. 46,49,50 A reduced ROAM correlates with a reduced function of the CMP. 51 The CMP is the main factor in venous outflow because it transposes the most blood volume specifically in the body weight transfer manoeuvre.…”

“…(43)(44)(45) Ambulatory compression therapy, on the other hand, is the cornerstone of venous leg ulcer treatment as an intervention on its own or in combination with varicose vein removal. (46,47) Ambulatory compression therapy increases healing rates of venous leg ulcers and reduces wound days using two-layered (or four-layered) bandaging or graduated compression stockings. When ambulatory compression therapy is provided in combination with varicose vein removal, higher healing rates and a higher reduction in wound days can be accomplished.…”

“…Comorbidity in the lower extremities will often lead to a reduction in the Range Of Ankle Motion (ROAM), or directly to a reduced function of the CMP which results in an altered or reduced mobility. 45 Comorbidities resulting in reduced mobility that are associated with the development of a VLU are rheumatic diseases 46 , peripheral arterial disease 47 , and neuropathy 45 . The reduced mobility in the lower extremities leads to a restriction in optimally utilizing the foot plate.…”

“…(45) Furthermore, including specific exercises in combination with compression therapy is important, because bandages can lead to a reduced range of ankle motion. (46) As the results in Chapter 5 show, a restriction of the range of ankle motion is associated with more severe chronic venous disease and is, therefore, an important factor to take into consideration while managing the progression of chronic venous disease.…”