Vascular Diseases Center, Translational Surgery Unit, University of Ferrara, Ferrara, Italy; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Md.
Angiology Department, Clinica MD Barbantini, Lucca, Italy.
J Vasc Surg Venous Lymphat Disord. 2019 Jul;7(4):557-561. doi: 10.1016/j.jvsv.2019.02.001. Epub 2019 Mar 25.
Despite the modern appeal of wearing compressive garments during physical activities, the literature is lacking in quality data and controversial in the investigations dealing with the pathophysiologic mechanism by which graduated compression stockings (GCS) affect the calf pump activation in healthy individuals. The aim of the investigation was to provide insight into the clinical effects of GCS use during a standardized walking exercise.
Twenty physically active healthy volunteers (mean age, 34 ± 5 years; body mass index, 22 ± 2 kg/m) underwent lower limb ultrasound scanning to exclude vascular impairment. All individuals performed continuous aerobic exercise, walking for 30 minutes on a treadmill, under cardiac monitoring, at 70% of individual estimated maximal heart rate according to the Tanaka equation. The study population performed the standardized walk without GCS (baseline) and at 1 week performed the same standardized walk wearing knee-length 20 to 30 mm Hg GCS (compression). All individuals underwent a lower limb volume assessment by truncated cone formula before and after the walk and a perceived exertion assessment by means of the validated Borg scale at the end of the exercise protocol.
All individuals had normal venous and arterial ultrasound examination findings. No significant postural defects were reported. Both legs were assessed in all 20 individuals for a total of 40 cases with and 40 cases without GCS. In the baseline group, the median (interquartile range) lower limb volume changed from 2496 (770) mL before exercise to 2512 (805) mL (P = .2597) after exercise. The compression group reported a significant lower limb volume change from 2466 (670) mL before exercise to 2276 (567) mL (P = .0001) after exercise. Mean perceived exertion was 13 (11) and 11 (1) in the baseline and compression groups, respectively (P = .0001). The interface pressure exerted by the GCS was 24 (2) mm Hg. No complaints in terms of discomfort were reported after use of GCS.
In healthy individuals, GCS (24 [2] mm Hg) use during a continuous standardized walk of 30 minutes is associated with a significant decrease in lower limb volume and a decrease in perceived exertion. The mechanism by which GCS impart their effect during physical activity may involve improved muscle pump function and reductions in inflammatory pathways. Further study will need to validate the mechanisms of the function of GCS used during physical exercise.
尽管在体育活动中穿压缩服具有现代吸引力，但文献中缺乏高质量的数据，并且在研究逐渐加压弹力袜（GCS）如何影响健康个体的小腿泵激活的病理生理机制方面存在争议。本研究旨在深入了解 GCS 在标准化步行运动中的临床应用效果。
20 名身体活跃的健康志愿者（平均年龄 34±5 岁；体重指数 22±2kg/m²）接受下肢超声检查以排除血管损伤。所有个体均在心脏监测下，根据 Tanaka 方程以个体估计最大心率的 70%进行连续有氧运动，即 treadmill 上 30 分钟的步行运动。研究人群在未穿 GCS（基线）的情况下进行标准化行走，1 周后穿着膝长 20-30mmHg 的 GCS（加压）进行相同的标准化行走。所有个体在行走前后均采用截顶圆锥公式进行下肢容量评估，并在运动方案结束时使用经过验证的 Borg 量表进行感知用力评估。
所有个体的静脉和动脉超声检查结果均正常。未报告明显的姿势缺陷。20 名个体的双腿均进行了 40 次未穿 GCS 和 40 次穿 GCS 的评估，共 80 次评估。在基线组中，下肢容量中位数（四分位距）从运动前的 2496（770）mL 变为运动后的 2512（805）mL（P=.2597）。加压组报告下肢容量从运动前的 2466（670）mL 显著减少至运动后的 2276（567）mL（P=.0001）。基线组和加压组的平均感知用力分别为 13（11）和 11（1）（P=.0001）。GCS 施加的界面压力为 24（2）mmHg。使用 GCS 后，无任何不适报告。
在健康个体中，连续标准化行走 30 分钟时使用 GCS（24[2]mmHg）与下肢容量显著减少和感知用力减少相关。GCS 在体育活动中发挥作用的机制可能涉及改善肌肉泵功能和减少炎症途径。需要进一步的研究来验证在体育锻炼中使用 GCS 的功能机制。
