Better wearing comfort of knee-length elastic compression stockings with an interface pressure of 18-21 mmHg compared to 23-32 mmHg in elderly people after a one day trial - Influence on foot deformities, rheumatism and arthritis

Abstract

Background: Although the efficacy of compression therapy through knee-length compression stockings with an interface pressure of 18-21 mmHg for leg oedemas has been confirmed by many studies, 91% of patients are still treated with a higher interface pressure.

Method: In this prospective open randomised monocentric study 19 patients (age ≥65, movement restrictions and symptomatic leg oedema) received knee-length compression stockings with an interface pressure of 18-21 mmHg (stocking type 1) and 23-32 mmHg (stocking type 2). On two consecutive days each of the two compression stocking types were worn for at least 8 hours. After this test period, both stocking types were assessed subjectively and skin changes were recorded.

Result: A significantly (p-value <0.001) subjective improvement of the symptoms and complaints based on leg oedema was reported with the knee-length compression stockings. The Stocking type 1 recorded a significantly (p = 0,045) better wearing comfort. In addition, the Stocking type 2 was significantly too large amongst women in the front foot area (p = 0.044). The most common side effects were constrictions on the proximal lower leg (stocking type 1 = 73,7% (14/19); stocking type 2 = 78,9% (15/19)). Subjects with arthritis (p = 0.006), hallux valgus (p = 0.034) and/or digitus flexus (p = 0.021) found the socking type 1 significantly more comfortable.

Conclusion: In order to achieve optimal patient compliance it is recommended to prescribe knee-length compression stockings with an interface pressure of 18-21 mmHg if the following criteria are met: age ≥65 years, female sex, arthritis, digitus flexus (claw toe) or hallux valgus.

Keywords: Chronic leg oedema; chronic venous insufficiency; compression stocking therapy; quality of life; wearing comfort.