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Influence of compression stockings on the sensation of discomfort and the volume of the lower legs in healthy subjects during standing load.

BACKGROUND
Edema caused by orthostasis is a common clinical picture in the medical and occupational context. Medical compression therapy with compression stockings (CS) is considered a conservative therapeutic standard in edema therapy. The effect of CS on leg discomfort and the increase of the lower leg volume during a standing load still remains questionable. In addition, it is not entirely known whether there is a correlation between volume increase and discomfort in these individuals.


METHOD
A timed, controlled standing load of 15 min was conducted by the participants in this non-randomized controlled study to analyze the change in and correlation between lower leg volume increase and the occurrence of lower leg discomfort under compression therapy. Below-knee CS with an interface pressure of 23-32 mmHg were used. The lower leg volume was measured following previous studies using an optical three-dimensional volume (ml) measurement system, and sensations of discomfort and the urge to move were asked about using a numerical rating scale (NRS) of 0-10. The subjects conducted a leg movement for 15 s immediately after the standing period; the data were collected again subsequently. A correlation was calculated between the lower leg volume and the data regarding the discomfort and urge to move for each participant. The experiments had already been performed as part of a previous study including the same subjects who did not wear CS. The results of the study conducted here were compared with those of the participants who did not wear CS to investigate the effect of the CS.


RESULTS
Lower leg volume increased by an average of 27 ml (p <  0.001) (without CS: by 63 ml) during standing load in the right leg. During the leg movement after standing load, the lower leg volume increased by 5 ml (n.s.). The sensations of discomfort during the orthostasis increased by 2.6 points on the NRS (p <  0.001) (without CS: by 3.46 points) and decreased by 1.67 points (p <  0.001) during the leg movement shortly after the standing period. Participants' urge to move increased by 3.73 points on the NRS (p <  0.001) (without CS: by 3.47 points) while the participants performed the standing period and decreased by 2.73 points (p <  0.001) during the final movement exercise. A weakly significant correlation could be demonstrated between the increase in the lower leg volume and the occurrence of discomfort in 6 out of 13 subjects (p <  0.1), and between the increase in the lower leg volume and the urge to move in 8 out of 15 subjects (p <  0.1).


CONCLUSION
Standing loads and lack of movement lead to an increase in the lower leg volume and sensation of discomfort in venous healthy subjects wearing CS, which are reduced by wearing them (p <  0.001). A weakly significant mathematical correlation (Pearson's correlation coefficient) could be shown between the increase in the lower leg volume and the occurrence of the urge to move in 8 out of 15 subjects (p <  0.1) and between the increase in lower leg volume and the occurrence of leg discomfort in 6 out of 13 subjects (p <  0.1).