Stiffness of compression devices

S.T.R.I.D.E. Professional Guide to Compression Garment Selection for the Lower Extremity

“…9 In addition to the differences in stiffness observed among MCS of the same compression class, research has also demonstrated that the stiffness of an MCS has an impact on the haemodynamic effect, including decreased reflux, improved calf pump function, and decreased oedema formation. 3,7,13 Van Geest et al 13 found there was a statistically significant difference in capillary filtration rate, and consequently in the development of oedema, between compression garments with the same dosage but different stiffness. Hafner and Junger 3 observed similar findings in their randomised study demonstrating MCS of the same compression class or dosage, did not have the same acute effect on venous haemodynamics.…”

“…Numerous compression researchers have demonstrated that the higher the stiffness of a compression garment, the larger was the improvement of haemodynamic parameters and the more effective was the reduction in oedema. 3,7,13,20,39,57 CLINICAL PEARL Dosage describes the inward pressure that a garment exerts on the body as a result of its elastic recoil, while stiffness describes the resistance of the garment to the expansion, such as when an area of the body swells.…”

“…The leg position during measuring, the configuration and consistency at the measuring site, an individual's muscle girth and strength, the presence of fat, and the tissue composition have all been shown to affect the measured interface pressure. 6,7 In vivo static stiffness index (SSI) A simple but practical measurement of in vivo assessment of a textile, as proposed by Partsch, involves the measurement of the SSI, which is calculated as the pressure difference between the standing and supine positions. 59 To measure the SSI, IP is measured at B1 in two body positions, supine resting and standing, without change of the pressure sensor.…”

“…Multiple researchers have found similar excellent correlation between SSI and DSI in vitro and in vivo testing. 4,7,20,5,56,63 Although the research has demonstrated correlation between SSI and DSI, affording a standardised method for comparison of compression products, Hirai and Partsch acknowledged the inability of this method to replicate in vivo conditions, such as altered limb shape or altered tissue texture that are present in pathology. Thus, the applicability of these findings in clinical practice is limited.…”

“…Thus, for patients with chronic oedema states due to venous hypertension, a compression garment that exerts a low comfortable pressure at rest, but a strong pressure during standing and walking to counteract ambulatory venous hypertension is ideal. 2,7,66 The importance of oscillating forces for lymphatic drainage may explain why stiff compression material achieves a massaging effect in combination with muscular activity and is the preferred material for acute decongestion for individuals with lymphoedema. Stiffer compressive textiles produce a greater massaging effect by generating greater amplitude of change in IP with movement.…”