Can Compression Garments Reduce the Deleterious Effects of Physical Exercise on Muscle Strength? A Systematic Review and Meta-Analyses

Background

The use of compression garments (CGs) during or after training and competition has gained popularity in the last few decades. However, the data concerning CGs’ beneficial effects on muscle strength-related outcomes after physical exercise remain inconclusive.

Objective

The aim was to determine whether wearing CGs during or after physical exercise would facilitate the recovery of muscle strength-related outcomes.

Methods

A systematic literature search was conducted across five databases (PubMed, SPORTDiscus, Web of Science, Scopus, and EBSCOhost). Data from 19 randomized controlled trials (RCTs) including 350 healthy participants were extracted and meta-analytically computed. Weighted between-study standardized mean differences (SMDs) with respect to their standard errors (SEs) were aggregated and corrected for sample size to compute overall SMDs. The type of physical exercise, the body area and timing of CG application, and the time interval between the end of the exercise and subsequent testing were assessed.

Results

CGs produced no strength-sparing effects (SMD [95% confidence interval]) at the following time points (t) after physical exercise: immediately ≤ t < 24 h: − 0.02 (− 0.22 to 0.19), p = 0.87; 24 ≤ t < 48 h: − 0.00 (− 0.22 to 0.21), p = 0.98; 48 ≤ t < 72 h: − 0.03 (− 0.43 to 0.37), p = 0.87; 72 ≤ t < 96 h: 0.14 (− 0.21 to 0.49), p = 0.43; 96 h ≤ t: 0.26 (− 0.33 to 0.85), p = 0.38. The body area where the CG was applied had no strength-sparing effects. CGs revealed weak strength-sparing effects after plyometric exercise.

Conclusion

Meta-analytical evidence suggests that wearing a CG during or after training does not seem to facilitate the recovery of muscle strength following physical exercise. Practitioners, athletes, coaches, and trainers should reconsider the use of CG as a tool to reduce the effects of physical exercise on muscle strength.

Trial Registration Number

PROSPERO CRD42021246753.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-022-01681-4.

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.

Enhanced Cycling Time-Trial Performance During Multiday Exercise With Higher-Pressure Compression Garment Wear

PURPOSE

Compression garments are widely used as a tool to accelerate recovery from intense exercise and have also gained traction as a performance aid, particularly during periods of limited recovery. This study tested the hypothesis that increased pressure levels applied via high-pressure compression garments would enhance "multiday" exercise performance.

METHODS

A single-blind crossover design, incorporating 3 experimental conditions-loose-fitting gym attire (CON), low-compression (LC), and high-compression (HC) garments-was adopted. A total of 10 trained male cyclists reported to the laboratory on 6 occasions, collated into 3 blocks of 2 consecutive visits. Each "block" consisted of 3 parts, an initial high-intensity protocol, a 24-hour period of controlled rest while wearing the applied condition/garment (CON, LC, and HC), and a subsequent 8-km cycling time trial, while wearing the respective garment. Subjective discomfort questionnaires and blood pressure were assessed prior to each exercise bout. Power output, oxygen consumption, and heart rate were continuously measured throughout exercise, with plasma lactate, creatine kinase, and myoglobin concentrations assessed at baseline and the end of exercise, as well as 30 and 60 minutes postexercise.

RESULTS

Time-trial performance was significantly improved during HC compared with both CON and LC (HC = 277 [83], CON = 266 [89], and LC = 265 [77] W; P < .05). In addition, plasma lactate was significantly lower at 30 and 60 minutes postexercise on day 1 in HC compared with CON. No significant differences were observed for oxygen consumption, heart rate, creatine kinase, or subjective markers of discomfort.

CONCLUSION

The pressure levels exerted via lower-limb compression garments influence their effectiveness for cycling performance, particularly in the face of limited recovery.

Association of Lower Limb Compression Garments During High-Intensity Exercise with Performance and Physiological Responses: A Systematic Review and Meta-analysis

BACKGROUND

Although compression garments are used to improve sports performance, methodological approaches and the direction of evidence regarding garments for use in high-intensity exercise settings are diverse.

OBJECTIVES

Our primary aim was to summarize the association between lower-limb compression garments (LLCGs) and changes in sports performance during high-intensity exercise. We also aimed to summarize evidence about the following physiological parameters related to sports performance: vertical jump height (VJ), maximal oxygen uptake (VO₂max), submaximal oxygen uptake (VO₂submax), blood lactate concentrations ([La]), and ratings of perceived exertion (RPE, 6-20 Borg scale).

METHODS

We searched electronic databases (PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov) and reference lists for previous reviews. Eligible studies included randomized controlled trials with athletes or physically active subjects (≥ 18 years) using any type of LLCG during high-intensity exercise. The results were described as weighted mean difference (WMD) with a 95% confidence interval (95% CI).

RESULTS

The 23 included studies showed low statistical heterogeneity for the pooled outcomes. We found that LLCGs yielded similar running performance to controls (50-400 m: WMD 0.06 s [95% CI - 1.99 to 2.11]; 800-3000 m: WMD 6.10 s [95% CI - 7.23 to 19.43]; > 5000 m: WMD 1.01 s [95% CI - 84.80 to 86.82]). Likewise, we found no evidence that LLCGs were superior in secondary outcomes (VJ: WMD 2.25 cm [95% CI - 2.51 to 7.02]; VO₂max: WMD 0.24 mL.kg^-1.min^-1 [95% CI - 1.48 to 1.95]; VO₂submax: WMD - 0.26 mL.kg^-1.min^-1 [95% CI - 2.66 to 2.14]; [La]: WMD 0.19 mmol/L [95% CI - 0.22 to 0.60]; RPE: WMD - 0.20 points [95% CI - 0.48 to 0.08]).

CONCLUSIONS

LLCGs were not associated with improved performance in VJ, VO₂max, VO₂submax, [La], or RPE during high-intensity exercise. Such evidence should be taken into account when considering using LLCGs to enhance running performance.

Muscle strength and stiffness in resistance exercise: Force transmission in tissues

Physical therapists and osteopaths want to know the quantitative force transmitted in the tissues during resistance exercise and also the relationship between tissue strength and the specific type of resistance exercise of the skeletal muscles. This paper uses the strain energy function for large deformations associated with the active and passive response of transversely isotropic skeletal muscle tissue to evaluate muscle strength and force transmitted in tissues during resistance exercises for the quadriceps muscle at the knee during isometric training exercise at different knee angles in vivo. It is found that after an exercise program, the muscle stiffness is halved when the bending angle of the knee increases from 50° to 100°. The muscle strength generated is marginally greater at 100° than at 50°. The stress transmitted in the lateral direction for 100° bending is double that for 50°.

Effect of lower body compression garments on hemodynamics in response to running session

Purpose. Compression garments are often worn during exercise and allegedly have ergogenic and/or physiological effects. In this study, we compared hemodynamics and running performance while wearing compression and loose-fit breeches. We hypothesized that in neutral-warm environment compression breeches impair performance by diminishing body cooling via evaporative sweat loss and redistributing blood from active musculature to skin leading to a larger rise in body temperature and prolonging recovery of hemodynamics after exercise. Methods. Changes in hemodynamics (leg blood flow, heart rate, and blood pressure during orthoclinostatic test), calf muscle tissue oxygenation, and skin and core temperatures were measured in response to 30 min running (simulation of aerobic training session) followed by maximal 400 m sprint (evaluation of running performance) in recreationally active females (25.1 ± 4.2 yrs; 63.0 ± 8.6 kg) wearing compression or loose-fit breeches in randomized fashion. Results. Wearing compression breeches resulted in larger skin temperature rise under the garment during exercise and recovery (by about 1°C, P < 0.05; statistical power > 85%), while core temperature dynamics and other measured parameters including circulation, running performance, and sensations were similar compared to wearing loose-fit breeches (P > 0.05). Conclusion. Compared with loose-fit breeches, compression breeches have neither positive nor negative physiological and performance effects for females running in thermoneutral environment.

Compression stockings do not improve muscular performance during a half-ironman triathlon race

PURPOSE

This study aimed at investigating the effectiveness of compression stockings to prevent muscular damage and preserve muscular performance during a half-ironman triathlon.

METHODS

Thirty-six experienced triathletes volunteered for this study. Participants were matched for age, anthropometric data and training status and placed into the experimental group (N = 19; using ankle-to-knee graduated compression stockings) or control group (N = 17; using regular socks). Participants competed in a half-ironman triathlon celebrated at 29 ± 3 °C and 73 ± 8% of relative humidity. Race time was measured by means of chip timing. Pre- and post-race, maximal height and leg muscle power were measured during a countermovement jump. At the same time, blood myoglobin and creatine kinase concentrations were determined and the triathletes were asked for perceived exertion and muscle soreness using validated scales.

RESULTS

Total race time was not different between groups (315 ± 45 for the control group and 310 ± 32 min for the experimental group; P = 0.46). After the race, jump height (-8.5 ± 3.0 versus -9.2 ± 5.3%; P = 0.47) and leg muscle power reductions (-13 ± 10 versus -15 ± 10 %; P = 0.72) were similar between groups. Post-race myoglobin (718 ± 119 versus 591 ± 100 μg/mL; P = 0.42) and creatine kinase concentrations (604 ± 137 versus 525 ± 69 U/L; P = 0.60) were not different between groups. Perceived muscle soreness (5.3 ± 2.1 versus 6.0 ± 2.0 arbitrary units; P = 0.42) and the rating of perceived effort (17 ± 2 versus 17 ± 2 arbitrary units; P = 0.58) were not different between groups after the race.

CONCLUSION

Wearing compression stockings did not represent any advantage for maintaining muscle function or reducing blood markers of muscle damage during a triathlon event.