Effect of Posture on the Pressure Exerted by Below-Knee Class II Compression Stockings on Normal Subjects

Abstract

Background: Below-knee elastic compression stockings are widely used for the treatment of chronic venous insufficiency. The exact amount of pressure exerted by these stockings on different parts of leg and in different postures remains controversial. Objective: To examine the pressure exerted by correctly fitted class II below knee compression stockings at different levels and postures in normal subjects. Methods: Seven healthy human volunteers (mean age 38 years) were fitted with CEN class II below-knee compression stockings. Interface pressure measurements were recorded at 4 cm intervals from the malleolus to the top of the stocking on the medial and lateral aspects of the leg in supine, sitting and standing postures. Results: The interface pressure at 4 cm and 32 cm above the medial malleolus was not significantly different from the recommended values for class II socks and did not change significantly with posture. In the supine position the pressure at the mid-calf (12 cm) was greater than at the ankle (p < 0.05), creating a reverse pressure gradient, which increased further on standing (p < 0.05). Conclusion: The pressure profile under correctly fitted class II socks varies with posture due to the change in shape of the leg. The resulting profile deviates from the theoretical ideal of a graduated pressure gradient that adapts with posture. The clinical significance of this effect is not known.

Measurement of Lower Leg Compression In Vivo: Recommendations for the Performance of Measurements of Interface Pressure and Stiffness

“… quality control of (new) compression products and/or compression techniques, 4,8,11,14,27,35–44 proof of concepts (e.g., do we apply graduated compression? ), 31,39,45,46 comparative clinical trials (to assess the “dosage” of compression applied to individual legs), 8,47 correlation with clinical outcomes or with physiological measurements, 6,24,38,48–56 documentation of clinical care (continuous monitoring), 8,19,43,57 training individuals how to apply compression bandages, 9,58–60 classification of compression bandages, compression stockings, velcro‐straps, multi‐layer compression systems, 8,71 validation of in vitro measurements, 20,30,56,61,62 compression of stockings to be indicated in mmHg instead of compression classes, 63 evaluation of the level of compression of a bandage, a stocking or a device over time 8,19,41,43,44,57 …”

“…After application of the compression device, pressures should be measured with the patient in both supine and standing positions 8,19,35,42,45,68 . Pressures may also be measured when the calf muscle and ankle joint pump are activated 13,15,19,27,28,48,66 .…”

Comparative In Vitro Study of Three Interface Pressure Sensors Used to Evaluate Medical Compression Hosiery

“…There is now a consensus 4 of medical and technical experts concerning the evaluation methods of compressive hosiery according to which measurement of the pressure exerted is important or even essential within the context of clinical trials. Some studies of compression stockings have provided results of in situ pressure measurements 5–25 . These studies were performed using different procedures and measuring systems, which makes comparison of results difficult.…”

The Investigation of the geometry changes of body legs with compression stocking in static position

“…A huge part of research on compression stockings is related to their medical usage [7][8][9] and published in medical scientific journals [9][10][11] because of medical aspects' study. It was found that the pressure profile exerted by elastic stockings varies with the posture [12] and exercise [13]. Furthermore, the changes in pressure vary from side to side of the leg.…”