A study about the reduction of “occupational edema” as a result of compression Some participants completely without symptoms
People who work sitting down or standing up a lot frequently suffer from tension, swelling and pain in the lower leg. This kind of discomfort can be significantly reduced with high-quality compression class Ccl 1 (18–21 mmHg) compression stockings. This was shown in Sophie Kindermann’s doctoral thesis, supervised by Dr. Helene Riebe, at Greifswald University Hospital, that prospectively examined 49 subjects compared with a knee-high stocking (8–10 mmHg).
According to the German Bitkom digital association, 50 percent of those employed in Germany have sedentary jobs1. As a consequence of working from home because of COVID-19, time spent sitting every day is expected to have significantly increased for many people – with unpleasant repercussions: extended periods of sitting down without changing position can lead to discomfort, such as pain, swelling and feelings of tension in the feet and lower legs. Edema can also develop, which is then referred to as “occupational edema”. Sophie Kindermann at Greifswald University Hospital examined how these symptoms can be preventively reduced2: “We wanted to show in our study to what extent medical compression stockings even of the lowest compression class, i.e. class 1, can alleviate orthostatic discomfort,” the young physician explains. “In addition to a change in lower leg volume, we also recorded the stockings’ wearing comfort.” This study was also her doctoral project, which was mainly supervised by Dr. Helene Riebe and Prof. Dr. Michael Jünger.
Compression improves venous return
In the randomized clinical study that was conducted prospectively in 2018 and in comparison with a knee-high stocking (8–10 mmHg, polyamide 60%, cotton 40%, 60 denier), the VenoTrain soft and VenoTrain soft S medical compression stockings (MCS) were used. Thanks to their contact pressure, both compression stockings have a positive effect on the skin’s microcirculation and support the functioning of insufficient venous valves, thus improving venous return.
The VenoTrain soft S is particularly comfortable in the foot area: a generously sized heel and the comfort zone around the instep provide additional room when the foot is angled during sitting. Both compression stockings are available in Ccl 2 as well as in the lowest compression class, Ccl 1 with 18–21 mmHg. “We chose the VenoTrain stockings in compression class 1 because the products are high-quality, their effectiveness is well documented, and we’ve had great feedback from patients,” Sophie Kindermann explains. As a comparison, they used a standard one-size knee-high stocking (8–10 mmHg, polyamide 60%, cotton 40%, 60 denier).
A total of 49 test subjects with an average age of 36 were examined. 34 subjects were healthcare professionals (physicians, nurses, medical technical assistants), and 14 subjects purely carried out desk work (secretaries, coordinators, research associates, engineers, administrative staff). One test subject spent half her time at her desk and the other half in field work. The participants tested each of the three stocking versions in three subsequent weeks. During each of the three weeks, a test stocking was worn for three days. On the following four days, no study test stocking was worn. Because of this “washout phase”, the baseline situation of the leg was the same at the beginning of each of the three test weeks.
Significantly reduced lower leg volume
Compression stockings increase the skin’s tissue pressure, with the result that fluid from the tissue can get to the heart, via the lymphatic system in particular, and no leg swelling will develop over the course of the day despite sedentary activities. The study now proves this: “Both compression stockings show a significant reduction in lower leg volume at the end of the respective wearing phase. The volume measurements were carried out using the clinically validated Bodytronic 600 measurement system. After the subjects wore the VenoTrain soft (18–21 mmHg), volumes decreased by 7.6 percent, with VenoTrain soft S (18–21 mmHg) by an average of 5.7 percent. In comparison, the volume reduction from wearing the knee-high stocking (8–10 mmHg) was quite low at 1.5 percent. “After using the two medical compression stockings for the lower leg, discomfort and edema formation are decreased or prevented,” Sophie Kindermann says.
“We can definitely recommend the wider use and more frequent prescribing of these class 1 stockings to people who sit or stand a lot.”
Top marks for the comfort of the compression stockings
The test subjects rated the wearing comfort of the three stockings using a questionnaire with a scale from zero (perfect) to ten (very poor). “Patients enjoyed wearing the VenoTrain compression stockings and rated their comfort as much better than that of the one-size knee-high stocking (8–10 mmHg),” Sophie Kindermann reports. “The test subjects assessed as remarkably positive that the compression stockings didn’t lose their shape, crease or slip but remained perfectly in position for the entire wearing phase, compared with the knee-high stocking (8–10 mmHg). This high degree of comfort was the same for both compression stockings.“
Significantly more energy and higher fitness levels in the mornings
When assessing the data, the physician came to the following conclusion regarding the investigated reduction in discomfort: “The VenoTrain soft S reduced congestion-related symptoms by 80 percent, VenoTrain soft by 75 percent and the knee-high stocking (8–10 mmHg) by 30 percent.” This assessment was recorded using a numerical rating scale from 0 (no symptoms) to 5 (very pronounced and bothersome). Another advantage: “All test subjects recorded significantly more energy and higher fitness levels in the mornings from wearing the compression stockings,” the physician says. Her conclusion: “We were able to demonstrate that Ccl 1 (18–21 mmHg) compression stockings significantly alleviate discomfort caused by extended periods of sitting or standing. We can therefore recommend prescribing class 1 stockings to people who sit or stand a lot and have corresponding symptoms3.”
2 Kindermann S.: Nebenwirkungen und Tragekomfort von Kompressionsstrümpfen bei Personen mit orthostatisch bedingter Missempfindung und Ödembildung aufgrund sitzender Tätigkeit; (unpublished data, Clinic and Outpatient Clinic for Skin Diseases at Greifswald University Hospital).
3 “Occupational edemas (standing or seated occupations)” are listed as an indication in the guidelines “Medizinische Kompressionstherapie der Extremitäten mit Medizinischem Kompressionsstrumpf (MKS), Phlebologischem Kompressionsverband (PKV) und Medizinischen adaptiven Kompressionssystemen (MAK)” – AWMF registration number: 037/005
Images: privat, stock.adobe.com/Aleksej
At Greifswald University Hospital, Sophie Kindermann conducted a study which investigated the effectiveness and comfort of medical compression stockings compared with a conventional knee-high stocking (8–10 mmHg) in cases of orthostatic discomfort and edema based on largely sedentary or standing activities.
- The compression stockings prevented the legs from swelling over the course of the day.
- The study participants rated the wearing comfort of the compression stockings as significantly better than that of the knee-high stocking (8–10 mmHg).
- Furthermore, discomfort was noticeably alleviated by the compression stockings. Some participants were completely free from symptoms.