Abstract
Background
Although compression garments are used to improve sports performance, methodological approaches and the direction of evidence regarding garments for use in high-intensity exercise settings are diverse.
Objectives
Our primary aim was to summarize the association between lower-limb compression garments (LLCGs) and changes in sports performance during high-intensity exercise. We also aimed to summarize evidence about the following physiological parameters related to sports performance: vertical jump height (VJ), maximal oxygen uptake (VO2max), submaximal oxygen uptake (VO2submax), blood lactate concentrations ([La]), and ratings of perceived exertion (RPE, 6–20 Borg scale).
Methods
We searched electronic databases (PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov) and reference lists for previous reviews. Eligible studies included randomized controlled trials with athletes or physically active subjects (≥ 18 years) using any type of LLCG during high-intensity exercise. The results were described as weighted mean difference (WMD) with a 95% confidence interval (95% CI).
Results
The 23 included studies showed low statistical heterogeneity for the pooled outcomes. We found that LLCGs yielded similar running performance to controls (50–400 m: WMD 0.06 s [95% CI − 1.99 to 2.11]; 800–3000 m: WMD 6.10 s [95% CI − 7.23 to 19.43]; > 5000 m: WMD 1.01 s [95% CI − 84.80 to 86.82]). Likewise, we found no evidence that LLCGs were superior in secondary outcomes (VJ: WMD 2.25 cm [95% CI − 2.51 to 7.02]; VO2max: WMD 0.24 mL.kg−1.min−1 [95% CI − 1.48 to 1.95]; VO2submax: WMD − 0.26 mL.kg−1.min−1 [95% CI − 2.66 to 2.14]; [La]: WMD 0.19 mmol/L [95% CI − 0.22 to 0.60]; RPE: WMD − 0.20 points [95% CI − 0.48 to 0.08]).
Conclusions
LLCGs were not associated with improved performance in VJ, VO2max, VO2submax, [La], or RPE during high-intensity exercise. Such evidence should be taken into account when considering using LLCGs to enhance running performance.
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References
Partsch H. The static stiffness index: a simple method to assess the elastic property of compression material in vivo. Dermatol Surg. 2006;31:625–30.
O’Meara S, Cullum NA, Nelson EA, et al. Compression for venous leg ulcers. Cochrane Libr. 2009;11:1–3.
Moseley AL, Carati CJ, Piller NB. A systematic review of common conservative therapies for arm lymphoedema secondary to breast cancer treatment. Ann Oncol. 2007;18:639–46.
Rinehart-Ayres ME. Conservative approaches to lymphedema treatment. Cancer. 1998;83:2828–32.
Qaseem A. Venous thromboembolism prophylaxis in hospitalized patients: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2011;155:625.
Sperlich B, Born DP, Swarén M, Kilian Y, Geesmann B, Kohl-Bareis M, et al. Is leg compression beneficial for alpine skiers? BMC Sports Sci Med Rehabil. 2013;5:18.
Ali A, Creasy RH, Edge JA. The effect of graduated compression stockings on running performance. J Strength Cond Res. 2011;25:1385–92.
Gupta A, Bryers JJ, Clothier PJ. The effect of leg compression garments on the mechanical characteristics and performance of single-leg hopping in healthy male volunteers. BMC Sports Sci Med Rehabil. 2015;7:10.
Stickford AS, Chapman RF, Johnston JD, Stager JM. Lower leg compression, running mechanics and economy in trained distance runners. Int J Sports Physiol Perform. 2014;10:76–83.
Dascombe BJ, Hoare TK, Sear JA, Reaburn PR, Scanlan AT. The effects of wearing undersized lower-body compression garments on endurance running performance. Int J Sports Physiol Perform. 2011;6:160–73.
Rimaud D, Messonnier L, Castells J, Devillard X, Calmels P. Effects of compression stockings during exercise and recovery on blood lactate kinetics. Eur J Appl Physiol. 2010;110:425–33.
Kraemer WJ, Bush JA, Bauer JA, Triplett-McBride NT, Paxton NJ, Clemson A, et al. Influence of compression garments on vertical jump performance in NCAA Division I volleyball players. J Strength Cond Res. 1996;10:180–3.
Doan BK, Kwon YH, Newton RU, Shim J, Popper EM, Rogers RA, et al. Evaluation of a lower-body compression garment. J Sports Sci. 2003;21:601–10.
Born DP, Holmberg HC, Goernert F, Sperlich B. A novel compression garment with adhesive silicone stripes improves repeated sprint performance—a multi-experimental approach on the underlying mechanisms. BMC Sports Sci Med Rehabil. 2014;6:21.
MacRae BA, Cotter JD, Laing RM. Compression garments and exercise: garment considerations, physiology and performance. Sports Med. 2011;41:815–43.
Born DP, Sperlich B, Holmberg HC. Bringing light into the dark: effects of compression clothing on performance and recovery. Int J Sports Physiol Perform. 2013;8:4–18.
Beliard S, Chauveau M, Moscatiello T, Cros F, Ecarnot F, Becker F. Compression garments and exercise: no influence of pressure applied. J Sports Sci Med. 2015;14:75–83.
Engel FA, Holmberg HC, Sperlich B. Is there evidence that runners can benefit from wearing compression clothing? Sports Med. 2016;46:1939–52.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264–9.
Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.
Riley RD, Higgins JPT, Deeks JJ. Interpretation of random effects meta-analyses. BMJ. 2011;342:d549.
Borg GA. Perceived exertion. Exerc Sport Sci Rev. 1974;2:131–53.
Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. http://handbook.cochrane.org.
Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61:991–6.
Egger M, Smith GD, Schneider M, Minder C, Mulrow C, Egger M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:597–9.
Bernhardt T, Anderson GS. Influence of moderate prophylactic compression on sport performance. J Strength Cond Res. 2005;19:292–7.
Bringard A, Perrey S, Belluye N. Aerobic energy cost and sensation responses during submaximal running exercise-positive effects of wearing compression tights. Int J Sports Med. 2006;27:373–8.
Kemmler W, von Stengel S, Köckritz C, Mayhew J, Wassermann A, Zapf J. Effect of compression stockings on running performance in men runners. J Strength Cond Res. 2009;23:101–5.
Rider BC, Coughlin AM, Hew-Butler TD, Goslin BR. Effect of compression stockings on physiological responses and running performance in Division III collegiate cross-country runners during a maximal treadmill test. J Strength Cond Res. 2014;28:1732–8.
Scanlan AT, Dascombe BJ, Reaburn PRJ, Osborne M. The effects of wearing lower-body compression garments during endurance cycling. Int J Sports Physiol Perform. 2008;3:424–38.
Sperlich B, Haegele M, Achtzehn S, Linville J, Holmberg HC, Mester J. Different types of compression clothing do not increase sub-maximal and maximal endurance performance in well-trained athletes. J Sports Sci. 2010;28:609–14.
Wahl P, Bloch W, Mester J, Born DP, Sperlich B. Effects of different levels of compression during sub-maximal and high-intensity exercise on erythrocyte deformability. Eur J Appl Physiol. 2012;112:2163–9.
Rivas E, Smith JD, Sherman NW. Leg compressions improve ventilatory efficiency while reducing peak and post exercise blood lactate, but does not improve perceived exertion, exercise economy or aerobic exercise capacity in endurance-trained runners. Respir Physiol Neurobiol. 2017;237:1–6.
Lovell DI, Mason DG, Delphinus EM, McLellan CP. Do compression garments enhance the active recovery process after high-intensity running? J Strength Cond Res. 2011;25:3264–8.
Varela-Sanz A, España J, Carr N, Boullosa DA, Esteve-Lanao J. Effects of gradual-elastic compression stockings on running economy, kinematics, and performance in runners. J Strength Cond Res. 2011;25:2902–10.
Burden RJ, Glaister M. The effects of ionized and nonionized compression garments on sprint and endurance cycling. J Strength Cond Res. 2012;26:2837–43.
Driller MW, Halson SL. The effects of wearing lower body compression garments during a cycling performance test. Int J Sports Physiol Perform. 2013;8:300–6.
Ali A, Caine MP, Snow BG. Graduated compression stockings: physiological and perceptual responses during and after exercise. J Sports Sci. 2007;25:413–9.
Barwood MJ, Corbett J, Feeney J, Hannaford P, Henderson D, Jones I, et al. Compression garments: no enhancement of high-intensity exercise in hot radiant conditions. Int J Sports Physiol Perform. 2013;8:527–35.
Faulkner JA, Gleadon D, McLaren J, Jakeman JR. Effect of lower limb compression clothing on 400-m sprint performance. J Strength Cond Res. 2013;27:669–76.
Goh SS, Laursen PB, Dascombe B, Nosaka K. Effect of lower body compression garments on submaximal and maximal running performance in cold (10 °C) and hot (32 °C) environments. Eur J Appl Physiol. 2011;111:819–26.
Venckūnas T, Trinkūnas E, Kamandulis S, Poderys J, Grūnovas A, Brazaitis M. Effect of lower body compression garments on hemodynamics in response to running session. Sci World J. 2014;2014:1–10.
Treseler C, Bixby WR, Nepocatych S. The effect of compression stockings on physiological and psychological responses after 5-km performance in recreationally active females. J Strength Cond Res. 2016;30:1985–91.
Del Coso J, Areces F, Salinero JJ, González-Millán C, Abián-Vicén J, Soriano L, et al. Compression stockings do not improve muscular performance during a half-ironman triathlon race. Eur J Appl Physiol. 2014;114:587–95.
Areces F, Salinero JJ, Abian-Vicen J, González-Millán C, Ruiz-Vicente D, Lara B, et al. The use of compression stockings during a marathon competition to reduce exercise-induced muscle damage: are they really useful? J Orthop Sports Phys Ther. 2015;45:462–70.
Ménétrier A, Mourot L, Bouhaddi M, Regnard J, Tordi N. Compression sleeves increase tissue oxygen saturation but not running performance. Int J Sports Med. 2011;32:864–8.
Moher D, Hopewell S, Schulz KF, Montori V, Gøtzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;10:28–55.
Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.
Knicker AJ, Renshaw I, Oldham ARH, Cairns SP. Interactive processes link the multiple symptoms of fatigue in sport competition. Sports Med. 2011;41:307–28.
Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004;34:105–16.
Lattimer CR, Kalodiki E, Kafeza M, Azzam M, Geroulakos G. Quantifying the degree graduated elastic compression stockings enhance venous emptying. Eur J Vasc Endovasc Surg. 2014;47:75–80.
Ibegbuna V, Delis KT, Nicolaides AN, Aina O. Effect of elastic compression stockings on venous hemodynamics during walking. J Vasc Surg. 2003;37:420–5.
Dermont T, Morizot L, Bouhaddi M, Ménétrier A. Changes in tissue oxygen saturation in response to different calf compression sleeves. J Sport Med. 2015;2015:857904.
Liu R, Lao TT, Kwok YL, Li Y, Ying MTC. Effects of graduated compression stockings with different pressure profiles on lower-limb venous structures and haemodynamics. Adv Ther. 2008;25:465–78.
Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc. 2000;32:70–84.
Poole DC, Jones AM. Oxygen uptake kinetics. Compr Physiol. 2012;2:933–96.
Faisal A, Dyson KS, Hughson RL. Prolonged ischaemia impairs muscle blood flow and oxygen uptake dynamics during subsequent heavy exercise. J Physiol. 2010;588:3785–97.
Grassi B, Gladden LB, Stary CM, Wagner PD, Hogan MC. Peripheral O2 diffusion does not affect V(O2) on-kinetics in isolated insitu canine muscle. J Appl Physiol. 1998;85:1404–12.
Grassi B, Gladden LB, Samaja M, Stary CM, Hogan MC. Faster adjustment of O2 delivery does not affect V(O2) on-kinetics in isolated in situ canine muscle. J Appl Physiol. 1998;85:1394–403.
Wilkerson DP, Rittweger J, Berger NJA, Naish PF, Jones AM. Influence of recombinant human erythropoietin treatment on pulmonary O2 uptake kinetics during exercise in humans. J Physiol. 2005;568:639–52.
Ali A, Creasy RH, Edge JA. Physiological effects of wearing graduated compression stockings during running. Eur J Appl Physiol. 2010;109:1017–25.
Jones AM, Grassi B, Christensen PM, Krustrup P, Bangsbo J, Poole DC. Slow component of VO2 kinetics: mechanistic bases and practical applications. Med Sci Sports Exerc. 2011;43:2046–62.
Berry MJ, McMurray RG. Effects of graduated compression stockings on blood lactate following an exhaustive bout of exercise. Am J Phys Med. 1987;66:121–32.
Nielsen HV. External pressure-blood flow relations during limb compression in man. Acta Physiol Scand. 1983;119:253–60.
Styf J. The influence of external compression on muscle blood flow during exercise. Am J Sports Med. 1990;18:92–5.
Sperlich B, Born DP, Kaskinoro K, Kalliokoski KK, Laaksonen MS. Squeezing the muscle: compression clothing and muscle metabolism during recovery from high intensity exercise. PLoS One. 2013;8:e60923.
Nishiyasu T, Nagashima K, Nadel ER, Mack GW. Human cardiovascular and humoral responses to moderate muscle activation during dynamic exercise. J Appl Physiol. 2000;88:300–7.
Billat LV. Use of blood lactate measurements for prediction of exercise performance and for control of training. recommendations for long-distance running. Sports Med. 1996;22:157–75.
Faude O, Kindermann W, Meyer T. Lactate threshold concepts: how valid are they? Sports Med. 2009;39:469–90.
Dittrich N, de Lucas RD, Maioral MF, Diefenthaeler F, Guglielmo LGA. Continuous and intermittent running to exhaustion at maximal lactate steady state: neuromuscular, biochemical and endocrinal responses. J Sci Med Sport. 2013;16:545–9.
Marcora SM, Staiano W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol. 2009;106:857–64.
Marcora SM, Staiano W. The limit to exercise tolerance in humans: mind over muscle? Eur J Appl Physiol. 2010;109:763–70.
Blanchfield AW, Hardy J, De Morree HM, Staiano W, Marcora SM. Talking yourself out of exhaustion: the effects of self-talk on endurance performance. Med Sci Sports Exerc. 2014;46:998–1007.
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This study was supported by the Fundo de Incentivo à Pesquisa e Eventos from the Hospital de Clínicas de Porto Alegre (FIPE/HCPA). Ricardo Stein and Daniel Umpierre receive research productivity funding from the Brazilian National Council for Scientific and Technological Development (CNPq). Lucas Helal receives PhD funding support from the CAPES (Coordination for the Improvement of Higher Education Personnel) Foundation.
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César Augusto da Silva, Lucas Helal, Roberto Pacheco da Silva, Karlyse Claudino Belli, Daniel Umpierre, and Ricardo Stein declare that they have no conflicts of interest relevant to the content of this review.
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da Silva, C.A., Helal, L., da Silva, R.P. et al. Association of Lower Limb Compression Garments During High-Intensity Exercise with Performance and Physiological Responses: A Systematic Review and Meta-analysis. Sports Med 48, 1859–1873 (2018). https://doi.org/10.1007/s40279-018-0927-z
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DOI: https://doi.org/10.1007/s40279-018-0927-z