Intramuscular pressures beneath elastic and inelastic leggings

Abstract

Leg compression devices have been used extensively by patients to combat chronic venous insufficiency and by astronauts to counteract orthostatic intolerance following spaceflight. However, the effects of elastic and inelastic leggings on the calf muscle pump have not been compared. The purpose of this study was to compare in normal subjects the effects of elastic and inelastic compression on leg intramuscular pressure (IMP), an objective index of calf muscle pump function. IMP in soleus and tibialis anterior muscles was measured with transducer-tipped catheters. Surface compression between each legging and the skin was recorded with an air bladder. Subjects were studied under three conditions: (1) control (no legging), (2) elastic legging, and (3) inelastic legging. Pressure data were recorded for each condition during recumbency, sitting, standing, walking, and running. Elastic leggings applied significantly greater surface compression during recumbency (20±1 mm Hg, mean±SE) than inelastic leggings (13±2 mm Hg). During recumbency, elastic leggings produced significantly higher soleus IMP of 25±1 mm Hg and tibialis anterior IMP of 28±1 mm Hg compared to 17±1 mm Hg and 20±2 mm Hg, respectively, generated by inelastic leggings and 8±1 mm Hg and 11±1 mm Hg, respectively, without leggings. During sitting, walking, and running, however, peak IMPs generated in the muscular compartments by elastic and inelastic leggings were similar. Our results suggest that elastic leg compression applied over a long period in the recumbent posture may impede microcirculation and jeopardize tissue viability. On the other hand, inelastic leggings do not compress leg tissues at levels above 20 mm Hg during recumbency. Therefore inelastic leggings may be more effective in improving venous circulation in the legs of patients with chronic venous insufficiency.