Compression enhances lower‐limb somatosensation in individuals with poor somatosensation, but impairs performance in individuals wth good somatosensation

The effect of a combined compression-tactile stimulating sock on postural stability

Previous research has demonstrated that postural stability may be improved by increasing stimulation to the somatosensory system. Wearing lower limb compression garments or textured in-soles have been found to be effective short-term methods for improving postural stability, hypothesized to be due to enhanced tactile feedback. The aim of this study was to assess whether a combined compression-tactile sock increases postural stability in healthy adults, compared to barefoot. Participants completed a sensory organization test (SOT) to assess postural stability under two conditions: (a) barefoot, and (b) wearing a compression sock with a textured inner lining (small rubber nodules on the skin side of the sole). SOT composite scores and three sensory scores - somatosensory, vestibular, visual - were assessed between the two conditions to identify whether wearing the socks was associated with enhanced postural stability. Comparisons between the two conditions were analyzed via a paired t-test for the (i) entire group, and an ANOVA when the group was split into (ii) "high performers" and "low performers", according to their baseline performance on the SOT. Fifty-four participants (28 females, 26 males, mean age 40 ± 14 years) completed the study. SOT scores were not different between the compression-tactile sock and barefoot conditions when analyzed as an entire group (p > 0.0125), or when the group was split into performance groups (p > 0.0125). These findings demonstrate that, for healthy adults, mixed compression and tactile stimulation socks do not appear to be associated with improved postural stability, when measured using the sensory organization test. Although prior research indicates that wearing a compression-tactile sock improves somatosensory acuity compared to being barefoot, these benefits do not seem to carry over to postural stability. It may be that in healthy adults, the additional sensory feedback becomes redundant, or the SOT is not challenging enough for this study population.

Influence of compression garments on proprioception: A systematic review and meta-analysis

Compression garments (CGs) are commonly used in rehabilitation and sports contexts to enhance performance and speed up recovery. Despite the growing use of CGs in recent decades, there is no unanimous consensus on their overall influence on joint proprioception. In this current meta-analysis, we aim to fill this knowledge gap by assessing the impact of CGs on joint proprioception. We conducted a literature search across seven databases and one registry. Ultimately, we included 27 studies with 671 participants. The meta-analysis revealed that wearing CGs resulted in a significant reduction in absolute error during joint position sensing (Hedges' g: -0.64, p = 0.006) as compared to no CGs. However, further analyses of variables such as constant error (p = 0.308), variable error (p = 0.541) during joint position sense tests, threshold to detect passive motion (p = 0.757), and active movement extent discrimination (p = 0.842) did not show a significant impact of CGs. The review also identified gaps in the reporting of certain outcomes, such as parameters of CGs, reporting of performance, individual-reported outcomes, and lack of placebo comparators. Consequently, this review provides guidelines for future studies that may facilitate evidence-based synthesis and ultimately contribute to a better understanding of the overall influence of CGs on joint proprioception.

The effect of compression and combined compression-tactile stimulation on lower limb somatosensory acuity

Background

Lower limb somatosensation and proprioception are important for maintaining balance. Research has shown that compression garments or exposure to textured surfaces, can enhance somatosensation however, little is known about the effect of combined compression and texture on somatosensory acuity in the lower limb. This study aimed to assess the effects of combined compression socks with a plantar textured sole, on lower limb somatosensory acuity.

Methods

Thirty participants completed a somatosensory acuity task (active movement extent discrimination apparatus; AMEDA) under three conditions: barefoot (control condition), standard knee-high compression sock (compression sock), and knee-high compression sock with internal rubber nodules situated on the sole (textured-compression sock). Somatosensory acuity was assessed between the different sock conditions for the (i) entire group, (ii) high performers, and (iii) low performers. It was hypothesized that low performers would see gains wearing either sock, but the greatest improvement would be in the textured-compression sock condition.

Results

AMEDA scores were not significantly different between conditions when the entire group was analyzed (p = 0.078). The low performers showed an improvement in somatosensory acuity when wearing the compression sock (p = 0.037) and the textured compression sock (p = 0.024), when compared to barefoot, but there was no difference between the two sock conditions (p > 0.05). The high performers did not show any improvement (p > 0.05 for all).

Conclusion

These findings demonstrate that additional sensory feedback may be beneficial to individuals with lower baseline somatosensory acuity but is unlikely to provide benefit for those with higher somatosensory acuity.

Impact of Sub-Clinical and Clinical Compression Socks on Postural Stability Tasks among Individuals with Ankle Instability

Compression socks are used by a very diverse group of individuals and may potentially have a greater impact on physically diminished or impaired individuals as opposed to healthy individuals. The purpose of this study was to compare the effects of sub-clinical (SC) and clinical (CL) compression socks among healthy (CON), copers (COP), and individuals with chronic ankle instability (CAI). Postural stability was evaluated in 20 participants (11 males and 9 females) using Balance Tracking System Balance platform (BTrackS™) during the modified clinical test of sensory integration in balance (mCTSIB) and limits of stability (LOS) tests. Postural sway parameters were analyzed using a mixed model repeated measures analysis of variance 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, and CL) × 4 (balance condition: EO, EC, EOF, and ECF) for mCTSIB and a 3 (group: CON, COP, and CAI) by 3 (compression condition: BF, SC, CL) × 4 (balance condition: FL, BL, BR, FR) for LOS. Results revealed significantly greater postural stability with both SC and CL compression socks when compared to barefoot conditions. However, no significant differences were observed among groups for compression socks grades. Both SC and CL compression socks may be effective in increasing postural stability.

Can Compression Garments Reduce Inter-Limb Balance Asymmetries?

Sensory cues provided by compression garments (CG) can improve movement accuracy and potentially reduce inter-limb balance asymmetries and the associated risk of injury. The aim of this study was to analyze the effects of CG wearing on inter-limb balance asymmetries. The hypothesis was that CG would reduce inter-limb balance asymmetries, especially in subjects with high level of asymmetries. Twenty-five sportsmen were recruited. They had to stand as motionless as possible in a one-leg stance in two postural tasks (stable and unstable), while wearing CG or not. Asymmetry indexes were calculated from center of foot pressure parameters. The effects of CG wearing were analyzed according to participants’ baseline level of asymmetry (i.e., without wearing CG) with correlation analyses. A qualitative analysis was also performed after a dichotomization procedure to check for a specific influence of CG on the dominant and non-dominant leg. Inter-limb balance asymmetries were reduced with CG in participants with high levels of asymmetries at baseline. However, asymmetries were increased with CG in participants with low levels of asymmetries at baseline. The dominant leg was more affected by this negative effect. CG wearing could reduce inter-limb balance asymmetries and the related injury risk in subjects with high levels of inter-limb balance asymmetries at baseline. Nevertheless, CG should not be used in individuals with low baseline balance asymmetries since it can increase asymmetries in these subjects, likely by confusing and overloading the sensorimotor processing on the dominant leg.

Putting the Squeeze on Compression Garments: Current Evidence and Recommendations for Future Research: A Systematic Scoping Review

Background

Compression garments are regularly worn during exercise to improve physical performance, mitigate fatigue responses, and enhance recovery. However, evidence for their efficacy is varied and the methodological approaches and outcome measures used within the scientific literature are diverse.

Objectives

The aim of this scoping review is to provide a comprehensive overview of the effects of compression garments on commonly assessed outcome measures in response to exercise, including: performance, biomechanical, neuromuscular, cardiovascular, cardiorespiratory, muscle damage, thermoregulatory, and perceptual responses.

Methods

A systematic search of electronic databases (PubMed, SPORTDiscus, Web of Science and CINAHL Complete) was performed from the earliest record to 27 December, 2020.

Results

In total, 183 studies were identified for qualitative analysis with the following breakdown: performance and muscle function outcomes: 115 studies (63%), biomechanical and neuromuscular: 59 (32%), blood and saliva markers: 85 (46%), cardiovascular: 76 (42%), cardiorespiratory: 39 (21%), thermoregulatory: 19 (10%) and perceptual: 98 (54%). Approximately 85% (n = 156) of studies were published between 2010 and 2020.

Conclusions

Evidence is equivocal as to whether garments improve physical performance, with little evidence supporting improvements in kinetic or kinematic outcomes. Compression likely reduces muscle oscillatory properties and has a positive effect on sensorimotor systems. Findings suggest potential increases in arterial blood flow; however, it is unlikely that compression garments meaningfully change metabolic responses, blood pressure, heart rate, and cardiorespiratory measures. Compression garments increase localised skin temperature and may reduce perceptions of muscle soreness and pain following exercise; however, rating of perceived exertion during exercise is likely unchanged. It is unlikely that compression garments negatively influence exercise-related outcomes. Future research should assess wearer belief in compression garments, report pressure ranges at multiple sites as well as garment material, and finally examine individual responses and varying compression coverage areas.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01604-9.