Compression Stockings versus Neuromuscular Electrical Stimulation Devices in the Management of Occupational Leg Swelling

Abstract

Background Occupational edema is reported to occur in healthy individuals after working in a sitting or standing position for extensive periods of time. It can be associated with feelings of tiredness, heaviness of the legs, and pain. Three licensed medical devices were compared in their management of occupational edema.

Subjects and Methods A total of 10 subjects were recruited from a clinical workspace. Right leg volume and great saphenous vein diameter was measured in the morning, and 6 hours later. On subsequent separate days, grade 2 graduated compression stockings (Active Compression Socks, Mediven, United Kingdom), geko (Firstkind Ltd, United Kingdom), and Revitive (Actegy Ltd, United Kingdom) were used bilaterally according to manufacturer's instructions.

Results Leg volumes increased by median 41 mL (p < 0.05) with no intervention. Percentage increase in leg volume was found to be significantly reduced by stockings compared with control (−1.7%, p < 0.01), and were more effective than electrical devices. Changes in vein diameter poorly correlate with leg volume changes.

Conclusion Occupational edema can occur over as little as 6 hours. All devices were well tolerated and reduced leg swelling. Stockings were the only device to significantly reduce leg swelling in this small trial.

Keywords

swelling - leg - edema - electrical stimulation - NMES - compression

Note

This article was previously presented as a poster at the Annual Meeting of the Society of Academic and Research Surgery, Durham, January 2015 (prize winner).

• References

• 1 Blättler W, Kreis N, Lun B, Winiger J, Amsler F. Leg symptoms of healthy people and their treatment with compression hosiery. Phlebology 2008; 23 (5) 214-221
• 2 Mosti G, Partsch H. Occupational leg oedema is more reduced by antigraduated than by graduated stockings. Eur J Vasc Endovasc Surg 2013; 45 (5) 523-527
• 3 de Boer EM, Broekhuijsen RW, Nieboer C , et al. Lycra Support Tights: Are They Effective?. Phlebology 1999; 14 (4) 162-166
• 4 Jungbeck C, Peterson K, Danielsson G , et al. Effects of Compression Hosiery in Female Workers with a Standing Profession. Phlebology 2002; 16 (3) 117-120
• 5 Partsch H, Winiger J, Lun B. Compression stockings reduce occupational leg swelling. Dermatol Surg 2004; 30 (5) 737-743 , discussion 743
• 6 Zhang Q, Styf J, Ekström L, Holm AK. Effects of electrical nerve stimulation on force generation, oxygenation and blood volume in muscles of the immobilized human leg. Scand J Clin Lab Invest 2014; 74 (5) 369-377
• 7 Navarro TP, Delis KT, Ribeiro AP. Clinical and hemodynamic significance of the greater saphenous vein diameter in chronic venous insufficiency. Arch Surg 2002; 137 (11) 1233-1237
• 8 Lane TRA, Shepherd AC, Gohel M , et al. Big Veins, Big Deal - Vein Diameter Affects Disease Severity, not Quality of Life. Journal of Vascular Surgery: Venous and Lymphatic Disorders 2013; 1: 101
• 9 Abraham P, Leftheriotis G, Desvaux B, Saumet M, Saumet JL. Diameter and blood velocity changes in the saphenous vein during thermal stress. Eur J Appl Physiol Occup Physiol 1994; 69 (4) 305-308
• 10 Tan CW, Coutts F, Bulley C. Measurement of lower limb volume: agreement between the vertically oriented perometer and a tape measure method. Physiotherapy 2013; 99 (3) 247-251
• 11 Stanton AW, Northfield JW, Holroyd B, Mortimer PS, Levick JR. Validation of an optoelectronic limb volumeter (Perometer). Lymphology 1997; 30 (2) 77-97
• 12 Hirai M, Iwata H, Miyazaki K , et al. Effect of gaiters on muscle pump activity in healthy volunteers. Phlebology 2013; 28 (6) 293-298
• 13 Tucker A, Maass A, Bain D , et al. Augmentation of venous, arterial and microvascular blood supply in the leg by isometric neuromuscular stimulation via the peroneal nerve. Int J Angiol 2010; 19 (1) e31-e37
• 14 Williams K, Moore H, Davies A. Haemodynamic changes with the use of neuromuscular electrical stimulation compared to intermittent pneumatic compression. Phlebology 2015; 30 (5) 365-372
• 15 Morris RJ, Woodcock JP. Evidence-based compression: prevention of stasis and deep vein thrombosis. Ann Surg 2004; 239 (2) 162-171
• 16 Barros MV, Labropoulos N, Ribeiro AL, Okawa RY, Machado FS. Clinical significance of ostial great saphenous vein reflux. Eur J Vasc Endovasc Surg 2006; 31 (3) 320-324
• 17 Ziaja D, Kocełak P, Chudek J, Ziaja K. Compliance with compression stockings in patients with chronic venous disorders. Phlebology 2011; 26 (8) 353-360
• 18 Raju S, Hollis K, Neglen P. Use of compression stockings in chronic venous disease: patient compliance and efficacy. Ann Vasc Surg 2007; 21 (6) 790-795
• 19 Corley GJ, Breen PP, Bîrlea SI, Serrador JM, Grace PA, Ólaighin G. Hemodynamic effects of habituation to a week-long program of neuromuscular electrical stimulation. Med Eng Phys 2012; 34 (4) 459-465
• 20 Lyons GM, Leane GE, Grace PA. The effect of electrical stimulation of the calf muscle and compression stocking on venous blood flow velocity. Eur J Vasc Endovasc Surg 2002; 23 (6) 564-566