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Falls are very serious health concerns among older adults. Providing additional cutaneous and proprioceptive feedback to older adults may enhance their balance control and therefore reduce the incidents of falls. This study aimed to investigate the acute and acclimated effect of wearing waist-to-above-ankle compression garments (CGs) on balance control in community-dwelling older adults. Thirty-one older adults participated in the study. The Timed Up and Go, Berg Balance Scale, and the Fall Risk Test of the Biodex Balance System were used in a random order to examine balance control in three testing sessions 1 week apart. Results indicated wearing CGs had a significant impact on the Timed Up and Go test (p <.001), Berg Balance Scale (p =.001), and the Fall Risk Test (p =.001). For the Timed Up and Go test, participants exhibited significant improvement in both the acute (8.68 vs. 7.91 s) and acclimated effect (7.91 vs. 7.41 s) of wearing CGs. For the Berg Balance Scale, participants showed significant improvement after wearing CGs for 1 week in comparison to the no CGs condition (55.77 vs. 55.39 points). For the Fall Risk Test, participants showed a significant improvement in the acute effect of wearing CGs in comparison to the no CGs condition (1.55° vs. 1.31°). This exploratory study showed that wearing waist-to-above-ankle CGs provided a positive impact on balance control in healthy community-dwelling older adults. It lays the foundation for future studies with a larger sample size to investigate the potential benefits of wearing CGs in individuals with balance control deficits and/or other comorbidities. [ABSTRACT FROM AUTHOR]

No studies have reported ground reaction force (GRF) profiles of the repeated depth jump (DJ) protocols commonly used to study exercise-induced muscle damage. Furthermore, while compression garments (CG) may accelerate recovery from exercise-induced muscle damage, any effects on the repeated bout effect are unknown. Therefore, we investigated the GRF profiles of 2 repeated bouts of damage-inducing DJs and the effects of wearing CG for recovery. Nonresistance-trained males randomly received CG (n = 9) or placebo (n = 8) for 72 hours recovery, following 20 × 20 m sprints and 10 × 10 DJs from 0.6 m. Exercise was repeated after 14 days. Using a 3-way (set × bout × group) design, changes in GRF were assessed with analysis of variance and statistical parametric mapping. Jump height, reactive strength, peak, and mean propulsive forces declined between sets (P <.001). Vertical stiffness, contact time, force at zero velocity, and propulsive duration increased (P <.05). According to statistical parametric mapping, braking (17%–25% of the movement) and propulsive forces (58%–81%) declined (P <.05). During the repeated bout, peak propulsive force and duration increased (P <.05), while mean propulsive force (P <.05) and GRF from 59% to 73% declined (P <.001). A repeated bout of DJs differed in propulsive GRF, without changes to the eccentric phase, or effects from CG. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the use of compression therapy in the assessment and management of the venous and arterial aetiologies underlying leg ulceration as part of a holistic care plan, which was presented in an expert panel discussion held in October 2023.

Suboptimal management of leg ulcers is a growing burden on NHS nursing and financial resources (Guest et al, 2015; 2017; 2020). Compression therapy plays a crucial role in leg ulcer management by improving outcomes and reducing the burden of disease, however it is not routinely applied in practice and knowledge and confidence between bandage types and application styles often varies greatly (Guest et al, 2017; Hopkins, 2023). This article focuses on the importance of compression therapy in the management of leg ulceration and how to select the appropriate compression therapy based on the patient's presenting symptoms. It identifies possible barriers to application and offers potential strategies and suggestions to support the use of compression options in the community. [ABSTRACT FROM AUTHOR]

Lipedema is a chronic disorder primarily affecting women, characterized by abnormal fat deposition in the extremities, leading to pain, mobility issues, and psychological distress. These fat deposits are clear-cut and spare hands and feet. Often misdiagnosed as lymphedema, its prevalence remains uncertain due to a lack of universally accepted diagnostic criteria and difficulty in differentiating it from obesity or lymphedema. Genetic factors and hormonal influences are likely related to the pathophysiology of the disease, though the specific causes remain unknown. Imaging techniques may aid evaluation, but no definitive test exists, and diagnosis is made clinically. Conservative treatments such as lifestyle modifications and compression garments are considered first-line treatments, while surgical options such as liposuction and lipectomy are reserved for severe or refractory cases. Psychological support may be recommended, given lipedema's impact on quality of life and self-esteem. This review aims to present the current understanding of this condition, including challenges in diagnosis, current guideline recommendations for clinical care, and associated comorbid conditions. [ABSTRACT FROM AUTHOR]

Background: The management of pain after shoulder surgery typically includes the use of cryotherapy and the prescription of opioid analgesics. Much focus has been placed lately on the opioid epidemic, which in part is fueled by excessive prescription of opioid medication. Previous studies have found a combination of cryotherapy and compression effective at reducing analgesic consumption and increasing recovery in patients undergoing knee and spine surgery; however, efficacy in patients undergoing shoulder surgery has not been evaluated. Purpose: To evaluate the effectiveness of a cryo–pneumatic compression device on postoperative shoulder pain, narcotic use, and quality of life when compared with standard care cryotherapy. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: In total, 200 patients older than 18 years scheduled for unilateral shoulder surgery were enrolled. Patients were randomized to receive either postoperative cryo–pneumatic compression or standard care. The intervention group received a cryo–pneumatic device, while the standard care group received the treating surgeon's preferred method of postoperative care, including standard cryotherapy. Narcotic use was evaluated by the number of oral morphine milligram equivalents consumed during the postoperative period, as well as the time to cessation of narcotic use. Patient-reported outcome measures consisted of a numeric rating scale pain score, 36-item Short Form Survey, patient experience assessed using the net promoter score, and adverse events. Outcomes were evaluated at 2, 6, and 12 weeks postoperatively. Results: Patients receiving cryo–pneumatic compression reported a significant decrease in opioid consumption when compared with standard care (oral morphine milligram equivalents median, 56.1 vs 112; P =.02468). A significant increase in self-reported function was seen in the cryo–pneumatic compression group at 2 weeks when compared with standard care (mean, 61.2 vs 54.2; P =.0412). Conclusion: In patients undergoing unilateral shoulder surgery, the use of cryotherapy with pneumatic compression, when compared with standard care, resulted in significantly decreased opioid consumption as well as increased function at 2 weeks. Registration: NCT04185064 (ClinicalTrials.gov identifier). [ABSTRACT FROM AUTHOR]

This retrospective study aimed to examine the effect of transcranial direct current stimulation (tDCS) combined with lower limb pneumatic compression during the postmatch recovery period in top-level professional male soccer players' physiological and perceptual markers of recovery status. During the 2022 season (baseline), pneumatic compression was performed as part of the recovery strategy, applied the day after official match play and psycho- physiological measurements (pain, sleep, perceived recovery, and creatine kinase [CK] sampling) were performed on the second day postmatch. During the 2023 season, the tDCS protocol was introduced, with its application being performed simultaneously (in conjunction) with pneumatic compression. Recovery sessions following 10 matches in the 2022 season and following 10 matches in the 2023 season were included in the analyses. Compared with 2022 (baseline; pneumatic compression isolated), the players perceived an increased recovery on the second day postmatch when tDCS was used in conjunction with the pneumatic compression (mean = 12%; p = 0.008) and rated improved sleep quality for the nights after applying tDCS combined with pneumatic compression (mean = 7.5%; p = 0.029). On the second day postmatch, a significant reduction was observed in muscle pain/soreness (mean = 64%; p < 0.0001) and the CK concentration decreased when baseline (pneumatic compression isolated) was compared with tDCS + pneumatic compression (mean = 76%; p = 0.001). In summary, combining pneumatic compression with tDCS may enhance the effects of both interventions, leading to greater overall improvements in recovery. Further research is warranted to confirm these findings and explore the underlying mechanisms in more detail. [ABSTRACT FROM AUTHOR]

Elastic yarns are the key component of high-performance compression garments. However, it remains a challenge to fabricate anti-fatigue yarns with high mechanical force and long elongation for generating compression garments with prolonged wear. In this paper, we report the development of anti-fatigue double-wrapped yarns with excellent mechanical properties by wrapping high-denier Spandex with nylon filaments in opposite twists. In particular, high-denier (560 D) Spandex as the core was untwisted, which can maximally reduce the interaction between the core and wrapping filaments, enabling high elongation of double-wrapped yarns. In addition, we chose 70 D nylon filaments with a tensile force of 3.87 ± 0.09 N as the wrapping materials to provide sufficient force for double-wrapped yarns. Notably, opposite twists were induced for the inner and outer wrapping filaments to achieve a balanced stable yarn structure. By systematically optimizing manufacturing parameters, including inner wrapping density, outer wrapping density, take-up ratio, and drafting ratio, we obtained double-wrapped yarn with excellent tensile stress (32.59 ± 0.82 MPa) and tensile strain (357.28% ± 9.10%). Notably, the stress decay rate of optimized yarns was only 12.0% ± 2.2%. In addition, the optimized yarn was used as the weft-lining yarn for generating weft-lined fabrics. The elastic recovery rate of the obtained fabric was decreased by only 2.6% after five cyclic stretches, much lower than the control fabric. Our design of anti-fatigue double-wrapped yarns could be widely used for fabricating high-performance compression garments. [ABSTRACT FROM AUTHOR]

A pressure of approximately 15–25 mmHg is used for effective compression therapy to prevent and treat hypertrophic scar formation in patients with burns. However, conventional facial compression garments present challenges owing to inadequate pressure distribution in curved areas such as the cheeks, around the mouth, and the slope of the nose. This study aimed to evaluate the utility of a custom-made 3D compression mask equipped with pressure sensors to treat facial burn scars. This single-blinded, prospective randomized controlled trial was conducted between May and October 2023, involving 48 burn scars in 12 inpatients with facial burns. We created the custom-made 3D compression mask equipped with pressure sensors, inner lined with biocompatible silicon, and a harness system using 3D printing technology, which can continuously monitor whether an appropriate pressure of 15–25 mmHg maintains. The biological scar properties, Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) scores in patients with facial burns were assessed before applying the compression mask and garment and at 4 and 12 weeks after application. Pre-application assessment of biological scar properties, VSS, and POSAS revealed no statistically significant differences between the 3D mask and control groups (p > 0.05 for all). Throughout the 12-week application, skin hydration and scar thickness significantly increased (p < 0.001) and reduced (p = 0.010), respectively , in the 3D mask group compared to the control group. Additionally, significant improvements in scar pliability (p = 0.004) and height (p = 0.009) of VSS, itching (p = 0.047), scar stiffness (p = 0.001), thickness (p = 0.011), and irregularity (p < 0.001) of POSAS-patient component, and scar thickness (p = 0.001), pliability (p = 0.012), and surface area (p = 0.027) of the POSAS-observer component were observed in 3D mask group throughout the 12-week application compared to the control group. The customized 3D compression mask equipped with pressure sensors significantly improved scar thickness, skin hydration, and various assessment scale parameters throughout the 12-week application. • Customized 3D compression mask maintains a pressure of approximately 15–25 mmHg. • Real-time pressure feedback aids scar management. • More improved facial scar thickness and skin hydration in the 3D mask group. • 3D compression masks were more effective than conventional compression garment. [ABSTRACT FROM AUTHOR]

The normal physiology of wound healing is impacted by sickle cell disease (SCD). With SCD, the red blood cells are misshapen due to an abnormality of haemoglobin S. Sickle cell leg ulcers usually occur around the ankle and have very poor healing rates, with a detrimental impact on quality of life, particularly as they usually develop in patients who are in their 20s (Marti-Carvajal et al, 2021). This article looks at some of the treatment options for SCD and whether these treatments have an impact, either positively or to the detriment of leg ulcer/wound healing. There are multiple physiological factors influencing the development of sickle cell leg ulcers, and their [ABSTRACT FROM AUTHOR]

Following the evaluation of leg ulcer services in one NHS Trust, it was identified that staff did not perceive lower limb wound care as a priority. Vascular assessments were repeatedly deferred, and follow-up compression visits became irregular. The team had limited capacity due to job vacancies, maternity leave and long-term sickness, leading to practitioners working approximately 300 hours extra per month. A solution was required to allow effective skill mix use and to improve patient care while improving wound healing rates. This paper presents a 6-month quality improvement programme (QiP) that was introduced within the Trust to improve the referral process for people with leg ulcers by promoting the effective use of staff time, reducing excessive workloads and implementing the effective use of compression hosiery, improving clinical outcomes for patients. Evaluation of the QiP demonstrated an improvement in consistency and continuity of care of the lower limb, aligning with the Trust's 5-year strategy plan to reduce the risk of lower limb amputations. Wound healing rates improved and facilitated the timely identification of potential vascular issues, leading to appropriate referrals. An evaluation of staff time highlighted team savings of 15,840 minutes/264 hours/35.2 days of nursing time per month, equating to an average financial saving of £5,944.75 in nursing time and £1,066 in dressings per month. [ABSTRACT FROM AUTHOR]

Objectives. Addressing the prevalent issue of size misfits in large-scale issued firefighter uniforms due to diverse and complex body morphologies, this article presents an objective method for intelligent garment sizing matching without subjective weighting. Methods. The method employs criteria importance through inter-criteria correlation (CRITIC) and the catastrophe progression method (CPM) for more accurate and reliable sizing. Traditional methods, reliant on limited indicators such as height and chest girth and often subjectively determined by experts, are prone to reliability concerns. Matching decisions made based on our approach are evidence-based, transparent and reproducible, thus minimizing subjectivity and expert intervention. Results. A case study of 388 cases validates the method's efficacy in providing garment size recommendations, surpassing traditional experience-based approaches by reducing subjective bias. Conclusion. Despite some differences, the optimal alternatives for examinees are almost consistent across the different methods. Compared with traditional subjective weighting methods, this method has potential advantages in situations such as large-scale matching of firefighter protective clothing where individual customization or direct try-on is not feasible. [ABSTRACT FROM AUTHOR]

The goal of this study was to inform standards of best practice in the use of cultured epidermal autograft (CEA), manufactured in the United States, for the treatment of patients with severe burns. The study was designed using the modified Delphi technique, a method for structuring group communication among experts to promote the development of consensus-based recommendations. Known areas of variability related to the stages of CEA treatment were identified by literature review prior to the study and were confirmed through qualitative interview with the experts. The areas included Preoperative Planning/Surgical Planning, Immediate Postoperative Care, and Rehabilitation and Long-Term Care. A list of 22 questions was developed based on interviews with the experts, and a 3-round Delphi technique was used to establish consensus (≥80% agreement). Following 3 rounds (quantitative, qualitative, and virtual roundtable meeting) of the Delphi study, important guidance for the use of CEA treatment in severely burned patients gained consensus. Final key recommendations included minimum burn limit for CEA treatment (30%-50% TBSA), ideal biopsy timing (1-2 days), number of grafts (enough to cover; adjust 72 hours before application), use of dermal substrates (recommended) and wide meshed autograft underlay (recommended), optimal CEA drying time per day (open air >6 hours), slings used if CEA placed on extremities (recommended), dressing changes (performed every day, all at once, with all layers removed down to bridal veil), CEA backing removal (10-14 days after placement), heat lamps (can be used to aid the wound in drying, depending on clinical judgment), initial activity restrictions lifted (beginning 10 days after backing removal), compression garments (introduced at approximately 2 months post-CEA surgery), and lasers (CO2 laser can be introduced between 3 and 6 months post-CEA surgery). [ABSTRACT FROM AUTHOR]

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Purpose: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. Design/methodology/approach: Five healthy amateur runners(three female and two male)were recruited for a 30-min running trial. They wear a Calf CG on their right leg (CG group), but not on their left leg(CON group). After obtaining the clothing pressure of Calf CG on the gastrocnemius lateral head (GL), gastrocnemius medial head (GM) and tibialis anterior(TA) of the right leg, surface electromyography (sEMG)of four muscles of GL, GM, TA and rectus femoris (RF) of the left and right legs were measured during running, and heart rate, cardiopulmonary rate, and human RPE were also measured. Blood bleed oxygen before and after the running trial were measured. The root mean square (RMS) of the characteristic values was selected as an index for the analysis of sEMG signals, and the data were analyzed using statistical and computational methods. Findings: The results showed that the indexes of heart rate, blood oxygen, and RPE were significantly increased, indicating that the subjects had reached the fatigue level. The comparison of mean clothing pressure at GL, GM and TA locations reveals that the TA location consistently exhibits the highest pressure for both types of CG. When wearing CG1, the mean clothing pressure at the GL and GM test points is greater than that of CG2(CG1-GL = 0.2059 kPa > CG2-GL = 0.148 kPa; CG1-GM = 0.1633 kPa > CG2-GM = 0.127 kPa). This is attributed to the double-layered fabric on the sides of CG1, which precisely covers the GL and GM areas, thereby resulting in higher mean clothing pressure at these locations compared to CG2. Conversely, the mean clothing pressure at the TA location for CG1 is lower than that for CG2(CG1-TA = 0.3852 kPa < CG2-TA = 0.426 kPa). The pressure exerted by the CG1 on the lower limb test areas has both positive and negative effects, though neither are statistically significant. The pressure exerted by CG2 alleviates fatigue at the directly affected locations GL and GM, but exerts excessive pressure on TA, resulting in a negative effect. Additionally, CG2 pressure alleviates fatigue at the indirectly affected location RF on the same side. Based on the specific clothing pressure data, it is concluded that when the pressure at the GM location is 0.127 kPa, 30 min of running has a fatigue-relieving effect. However, the pressure should not be excessively high, at 0.1633 kPa it exhibits an insignificant adverse effect. At the TA location, a garment pressure mean between 0.3852 and 0.426 kPa does not alleviate fatigue after 30 min of running, and the negative effect becomes more pronounced as the pressure increases. The pressure exerted by the CG at GL, GM, TA and RF locations shows significant changes from the previous time period during the 15–18 min interval after running. Therefore, in the design of CG, attention should be paid to the changes in clothing pressure effects on muscles during this specific time period. Originality/value: The few previous researches on the impact of calf compression garments (CG) on running performance while assessing physiological and perceptual factors. Therefore, this study investigated how the clothing pressure of two types of Calf CG, CG1 and CG2, affects muscle fatigue and activation during running. [ABSTRACT FROM AUTHOR]

In this review, we aimed to comprehensively summarize current literature on pathophysiology, relevance, diagnosis and treatment of fluid accumulation in patients with sepsis/septic shock. Fluid accumulation syndrome (FAS) is defined as fluid accumulation (any degree, expressed as percentage from baseline body weight) with new onset organ-failure. Over the years, many studies have described the negative impact of FAS on clinically relevant outcomes. While the relationship between FAS and ICU outcomes is well described, uncertainty exists regarding its diagnosis, monitoring and treatment. A stepwise approach is suggested to prevent and treat FAS in patients with septic shock, including minimizing fluid intake (e.g., by limiting intravenous fluid administration and employing de-escalation whenever possible), limiting sodium and chloride administration, and maximizing fluid output (e.g., with diuretics, or renal replacement therapy). Current literature implies the need for a multi-tier, multi-modal approach to de-resuscitation, combining a restrictive fluid management regime with a standardized early active de-resuscitation, maintenance fluid reduction (avoiding fluid creep) and potentially using physical measures such as compression stockings. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Continuous monitoring of lower extremity muscles is necessary, as the muscles support many human daily activities, such as maintaining balance, standing, walking, running, and jumping. However, conventional electromyography and physiological cross-sectional area methods inherently encounter obstacles when acquiring precise and real-time data pertaining to human bodies, with a notable lack of consideration for user comfort. Benefitting from the fast development of various fabric-based sensors, this paper addresses these current issues by designing an integrated smart compression stocking system, which includes compression garments, fabric-embedded capacitive pressure sensors, an edge control unit, a user mobile application, and cloud backend. The pipeline architecture design and component selection are discussed in detail to illustrate a comprehensive user-centered STIMES design. Twelve healthy young individuals were recruited for clinical experiments to perform maximum voluntary isometric ankle plantarflexion contractions. All data were simultaneously collected through the integrated smart compression stocking system and a muscle force measurement system (Humac NORM, software version HUMAC2015). The obtained correlation coefficients above 0.92 indicated high linear relationships between the muscle torque and the proposed system readout. Two-way ANOVA analysis further stressed that different ankle angles (p = 0.055) had more important effects on the results than different subjects (p = 0.290). Hence, the integrated smart compression stocking system can be used to monitor the muscle force of the lower extremities in isometric mode. [ABSTRACT FROM AUTHOR]

Background: Deep vein thrombosis (DVT) is common in patients undergoing gynecological surgery. We aimed to investigate the preventive efficacy in DVT of graduated compression stockings (GCS) alone and in combination with intermittent pneumatic compression (GCS + IPC) after gynecological surgery. Methods: In November 2022, studies on the use of GCS and GCS + IPC for the prevention of DVT after gynecological surgery were searched in seven databases. After literature screening and data extraction based on specific inclusion and exclusion criteria, preventive efficacies, including the risk of DVT and anticoagulation function, of GCS and GCS + IPC were compared. Finally, sensitivity analysis and Egger's test were performed to evaluate the stability of the meta-analysis. Results: Six publications with moderate quality were included in this meta-analysis. The results showed that GCS + IPC significantly reduced DVT risk (P = 0.0002) and D-dimer levels (P = 0.0005) compared with GCS alone. Sensitivity analysis and Egger's test showed that the combined results of this study were stable and reliable. Conclusions: Compared with GCS alone, GCS + IPS showed a higher preventive efficacy against DVT in patients following gynecological surgery. Highlights: GCS + IPC could significantly reduce the risk of DVT than GCS alone. GCS + IPC could significantly reduce the D-dimer than GCS alone. The involved studies were all RCTs and had no significant publication bias. Sensitivity analysis indicated that the combined results were stable. [ABSTRACT FROM AUTHOR]

Postural orthostatic tachycardia syndrome (POTS) is a chronic illness with unknown mortality and high morbidity, often diagnosed in the adolescent years. Published literature regarding POTS primarily focuses on the adult population, and guidance on treatment in pediatrics is sparse. The purpose of this clinical review is to evaluate the current literature on the management of POTS in pediatric patients. A search was conducted using the Cochrane database, Google Scholar, and PubMed. Studies were included if they evaluated the management of POTS, primarily in pediatric patients. Case reports and series were excluded. Eight published studies met the inclusion and exclusion criteria. To date, there are no US Food and Drug Administration-approved agents for the treatment of POTS. However, select pharmacological therapies have shown positive outcomes by addressing symptom origins, such as providing heart rate control, peripheral autonomic modulation, and targeting hypovolemia. Targeted pharmacological therapies studied in children and young adults include ivabradine, metoprolol, midodrine, pyridostigmine, intravenous crystalloid fluids, and fludrocortisone. Before adding pharmacotherapeutic interventions, non-pharmacologic interventions such as patient education, avoidance of symptom-triggering environments and medications, dietary fluid and sodium supplementation, exercise, and use of compression garments should be first attempted. Although the body of evidence for the management of POTS is expanding, additional research is needed to determine safe and efficacious dosing and establish clear guidelines for POTS in the pediatric population. [ABSTRACT FROM AUTHOR]

Skin tears are a major problem for patients and the health care professionals who treat them. Although opinions on their prevalence differ, it is estimated that they are encountered more frequently than pressure sores but are overlooked. Recommendations based on strong evidence were presented for the prevention and treatment of skin tears as classified by the International Skin Tear Advisory Panel. This case series includes the clinical status of 3 patients who developed skin tears while receiving care in the hospital, and the corrective and preventive practices related to skin tears. This article will contribute to raising the awareness of health care professionals in predicting, preventing, evaluating, and treating skin tears. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the suitability of current sizing systems adopted by brands, for an athletic female population and try to identify areas of improvement in current sizing and grading methods used. This information can be used to engineer accurately fitting lower-body sports compression leggings for the target demographic. Size and shape data of sixty-three athletic females was collected using 3D body scanning. The data was compared to size charts of three commercially available sports compression leggings manufactured by different brands as well as Alvanon's UK sizing and grading standards. Results show that athletic females are not catered for by current products. 28 women (44.44%) fell between sizes for at least one measurement across the three brands. Participant's measurements indicate differing body shapes to the standard 'hourglass' shape presented by the Alvanon UK sizing standards, used by companies as a basis for their sizing systems. [ABSTRACT FROM AUTHOR]

This article explores the use of pressure, vibration, and percussion in athletic recovery. It acknowledges that while these mechanical stimuli are commonly used in the recovery industry, their effectiveness and impact on various aspects of the body are not well-studied. The article emphasizes the importance of a personalized approach to using these techniques, taking into account individual factors such as user experience, muscle status, and tissue hydration. It also highlights the need for further research to understand the optimal use of these devices and the effects of different pressures, frequencies, amplitudes, and times. Overall, the article suggests that a personalized approach and accurate measurements are crucial for effective recovery strategies. [Extracted from the article]

Excessive compression after parotidectomy can lead to flap necrosis, while inadequate pressure can cause fluid accumulation. This study aimed to determine the optimal pressure and compression properties of different types of dressings. Initially, pressure measurements were taken for conventional Barton's dressing and a pre‐fabricated facial garment. In the subsequent phase, patients were randomly assigned to receive one of three types of pressure dressings: conforming bandage Barton's dressing, elastic bandage Barton's dressing or pre‐fabricated facial garment. The dressing types were randomly crossed over the following day. The mean pressure exerted by conventional Barton's dressing and the pre‐fabricated facial garment was 15.86 and 14.81 mmHg, respectively. There was no significant difference in the proportion of optimal pressure among the three types of pressure dressing (p‐values of 0.195, 0.555 and 0.089 at pre‐auricular, angle of mandible and post‐auricular sites, respectively). The pre‐auricular area demonstrated the highest proportion of optimal pressure, while suboptimal pressure was noted at the angle of the mandible and post‐auricular area. Dressing types had no effect on pressure stability (p = 0.37), and there was no significant difference in patient preference (p = 0.91). Conforming bandage Barton's dressing, elastic bandage Barton's dressing and pre‐fabricated facial garment exhibit comparable compressive properties, with no significant difference in patient preference and pressure stability. [ABSTRACT FROM AUTHOR]

• Enhanced machine vision system for qualitative garment classifications. • Clothes classification platform to separate post-consumed clothes. • Attention method to enhance the classification accuracy to human-level. • Sensitivity analysis to similar color, deformed and occluded garments by Grad-CAM. • Running stability analysis on work station and mobile device. The increasing volume of garment waste underscores the need for advanced sorting and recycling strategies. As a critical procedure in the secondary usage of waste clothes, qualitative classification of garments categorizes post-consumer clothes based on types and styles. However, this process currently relies on manual labor, which is inefficient, labor-intensive, and poses risks to workers. Despite efforts to implement automatic clothes classification systems, challenges persist due to visual complexities such as similar colors, deformations, and occlusions. In response to these challenges, this study introduces an enhanced intelligent machine vision system with attention mechanisms designed to automate the laborious and skill-demanding task of garment classification. Initially, a waste garment dataset comprising approximately 27,000 garments was curated using a self-developed automatic classification platform. Subsequently, the proposed attention method parameters were selected, and a series of benchmarks were conducted against state-of-the-art methods. Finally, the proposed system underwent a two-week online deployment to evaluate its running stability and sensitivity to similar colors, deformation, and occlusion in industrial production settings. The benchmarks indicate that the proposed method significantly improves classification accuracy across various models. The visualization interpretation of Grad-CAM reveals that the proposed method effectively handles complex environments by directing its focus toward garment-related pixels. Notably, the proposed system elevates classification accuracy from 68.28 % to human-level performance (>90 %) while ensuring greater running stability. This advancement holds promise for automating the classification process and potentially alleviating workers from labor-intensive and hazardous tasks associated with clothes recycling. [ABSTRACT FROM AUTHOR]

Objectives: To determine the demographics, outcomes, and healthcare utilization of patients with chronic venous insufficiency-associated lymphedema (CVI-LED) and the prevalence of lymphedema-specific therapy use after venous intervention. Methods: The IBM MarketScan Commercial and Medicare Claims Databases were examined for patients with CVI-LED. Patient demographics and the use of lymphedema-specific therapy before and after venous intervention were collected. Results: Of 85,601 LED patients identified, 8,406 also had a diagnosis of CVI. In the CVI-LED group, 1051 underwent endovenous ablation or venous stent placement. The use of lymphedema-specific therapy before and after venous intervention was 52% and 39%, respectively (p <.05). The mean time of initiation of LED-specific therapy following venous intervention was 265 days after ablation and 347 days after stent placement. Conclusion: Treating venous hypertension improves certain venous-related signs and symptoms of CVI. However, a significant proportion of patients have persistent edema which may reflect underlying, sub-optimally treated LED. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of compression therapy (CT) and the best compression modality choice are questioned in many clinical stages of chronic venous disease (CVD). This work aims to obtain information on indications, contraindications, and the best treatment option for CT in different clinical scenarios of CVD. Method: An online survey was made among members of the International Compression Club, experts in CT. Results: The experts apply CT in all clinical stages of CVD, even when evidence is missing. Regarding compression materials, experts use inelastic materials in the advanced stages of CVD and compression stockings in the early or chronic stages of CVD. Conclusion: The authors highlight the gap between experts' practical use of CT and evidence-based medicine results. They also suggested that, given the cost of randomized clinical trials aimed at specifying specific indications for different devices, artificial intelligence could be used for large-scale practice surveys in the future. [ABSTRACT FROM AUTHOR]

Lymphoedema effects approximately 200 000 people in UK. It is a chronic condition without a cure but there is much that can be done to ease and manage these complications. This article looks at the eight most common complications, providing advise on how to manage them, derived from the literature and the author's own experience. It also presents advise on how nurses can promote self-management of these complications, promoting patients' self-care. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Increasing pressures on healthcare resources require constant evaluation of the efficiency and effectiveness of provision, particularly for the rising number of vulnerable, elderly and obese patients. Practices regarding compression are arguably often ingrained due to its historical usage, with evidence from managing chronic venous insufficiency (CVI) underpinning its effectiveness. This evaluation explores the clinical benefit, impact, outcomes and cost-efficiencies of using an adjustable compression wrap system instead of previous care. 'Before-after design' observation of 50 patients captured baseline resource use, costs and outcomes (clinical and patient) at the time of assessment and again at a maximum of six-month follow-up. Data after using the adjustable compression wrap showed significantly improved clinician-reported outcomes: presence of wounds/leg ulceration (from 56% to 21%), incidence of cellulitis (halved), and reduced complexity/severity of lymphoedema. Additionally, patientreported outcomes, visual analogue scale (VAS) health score and LYMPROM© scores for pain, heaviness, shopping for shoes and clothes, and body image significantly improved. The mean number of community nurse visits per patient reduced from 11.6. to 9.1, but was not statistically significant (p-value 0.09). However, this evaluation found that over six months there was a mean cost reduction of over £383.70 per patient, which included the purchase price of the adjustable compression wrap system. [ABSTRACT FROM AUTHOR]

This study explored the relationship between the design of calf compression sleeves and the comfort of young women in long sitting and standing work environments. By studying the relationship between material elongation and comfort pressure, a prediction model was obtained. The characteristics of the calf models of 94 women were classified, and the influence of different calf characteristics on the pressure distribution and tensile value design was objectively analyzed through simulation tests. The samples were then produced based on the simulation results, and subjective and objective try-on tests and evaluations were carried out. The results show that the difference in the shape of the calf has a certain impact on the pressure distribution and comfort. The predicted value of the theoretical model is in good agreement with the actual test value. The sample can bring a suitable gradient pressure and meet the comfort requirements and safety standards. [ABSTRACT FROM AUTHOR]

Analysis of functional products for medical textiles indicates that there are plenty of different classifications of this group. Requirements for compression generated by compression garments differ depending on the application area, and even more, sometimes are contradictory and can be fulfilled in very different ways. The effectiveness of such products depends on mechanical and physical properties as well as psychological barriers. Currently, there is no uniform classification of compression classes, furthermore, there is no uniform standard, test method or technic for evaluation of the product' compression. Knitted compression fabrics are made by knitting together at least two types of yarns: a ground yarn which ensures stiffness and thickness and an elastomeric yarn which generates compression. Knitted compression products can be produced on both flat and circular knitting machines, though parameters and usage of production are different. Additional elements used in the structure of the compression product can significantly change the generated compression. Purposes and number of additional details depend on the application and functionality of the compression support, nevertheless, all rigid elements must be taken into account at the designing stage. Additional functionality like antimicrobial activity or thermal therapy can also be provided for compression knits. It is highly important to ensure the longevity of all functional properties. [ABSTRACT FROM AUTHOR]

To improve the moisture-wicking and elastic recovery properties of pure cotton corduroy fabric, the fabric was manufactured by blending Sorona fiber with cotton fiber. The mixed corduroy fabric was simulated and analyzed using fabric simulation software. The moisture absorption and thermal conductivity, color fastness to abrasion, elastic recovery and tensile properties of the fabrics were tested. A 3D garment display was conducted to analyze the pressure distribution of the fabric during wear. The results show the fabric texture is thick, the fabric velvet is round and clear, the fabric handle is soft and elastic. The simulation results of fabric are consistent with the actual weaving results. The fabric has good moisture transmission performance, the longitudinal hair moisture diffusion rate is higher than the transverse rate. Compared with pure cotton corduroy fabric, the breaking strength, elongation at break, color fastness to rubbing and elastic recovery rate of cotton/Sorona corduroy fabric are significantly improved. In the 3D garment display, the fabric experiences more concentrated pressure points on the upper body, with higher stress values at the sleeve shoulder and neckline, which may cause stretching deformation. Through simulation analysis, the friction damage of the above parts of the fabric can be reduced and the service life of the fabric can be prolonged. [ABSTRACT FROM AUTHOR]

The nine-year multicenter research project, titled REGman —Optimization of Training and Competition: Management of Regeneration in Elite Sports—aimed to advance the understanding of recovery management in sports and generate practical recommendations. In this article, we outline the overarching research program that links the specific research strands and outputs during the two federal funding cycles (2012–2021) and summarize the main project findings. The two-stage conceptual framework involved investigating monitoring measures for short-term fatigue and recovery, as well as assessing the efficacy of various recovery interventions. These interventions encompassed psychological relaxation and recovery strategies, sleep, cooling techniques like precooling, percooling, cold water immersion, or whole-body cryotherapy, compression garments, active recovery, stretching, heating interventions such as sauna or contrast water therapy, massage, and foam rolling. The findings revealed inconclusive or marginal effects of recovery interventions at the group level, while indicating possible interindividual differences in responses. Additionally, the findings highlighted the effectiveness of diverse monitoring measures, showing satisfactory sensitivity in tracking performance changes related to fatigue and recovery. The use of individualized reference ranges significantly improved classification accuracy compared to group-based reference ranges. Athletes and coaches are encouraged to prioritize fundamental aspects of training and recovery: meticulous training planning and execution, effective sleep management, and proper nutrition. Furthermore, monitoring and analyzing individual responses, even though it demands suitable methodologies and presents challenges in high-performance sports environments, can yield valuable insights for personalized recovery management. If these aspects are comprehensively addressed, and resources allow, additional recovery strategies might be explored. [ABSTRACT FROM AUTHOR]

The article focuses on the use of compression therapy in managing varicose veins, highlighting its efficacy in improving symptoms, reducing leg swelling, and enhancing quality of life for patients with chronic venous disease. Topics discussed include the indications for compression therapy, its role in different stages of varicose veins, and recommendations for its use before and after venous interventions.

Background: The effect of graduated elastic compression stockings (ECS) in the prevention of post-thrombotic syndrome (PTS) has been questioned since a large randomized trial found no prophylactic effect of ECS. Objective: To assess the effect of the wearing time of ECS on the incidence of post-thrombotic syndrome (PTS) after proximal deep venous thrombosis, we performed a meta-analysis of the incidence of PTS across randomized and observational studies. Method: PubMed, Embase and Cochrane databases were searched until 12 June 2023 for studies on the effect of ECS on PTS. References of eligible studies were also screened in order to identify other potential studies that might have been missed during the search. Results: Four studies comprising a total of 1467 patients met our inclusion criteria for early initiation and consistent use of ECS in patients with acute proximal DVT. ECS significantly reduced the incidence of mild-moderate PTS (OR: 0.48; 95% CI: 0.36–0.63) as well as severe PTS (OR: 0.44; 95% CI: 0.28–0.58). [ABSTRACT FROM AUTHOR]

Background: Cyanoacrylate endovenous ablation and closure of incompetent saphenous veins have become increasingly utilized since its approval for use in the United States in 2015. This increase in usage necessitates a societal update to guide treatment and ensure optimal and consistent patient outcomes. Method: The American Vein and Lymphatic Society convened an expert panel to write an updated Position Statement with explanations and recommendations for the appropriate use of cyanoacrylate endovenous ablation for patients with venous insufficiency. Result: A Position Statement was produced by the expert panel with recommendations for appropriate use, treatment technique, outcomes review, and potential adverse events. Their recommendations were reviewed, edited, and approved by the Guidelines Committee of the Society. Conclusion: This societal Position Statement provides a useful document for reference for physicians and venous specialists to assist in the appropriate use of cyanoacrylate endovenous ablation in the treatment of patients with venous insufficiency. [ABSTRACT FROM AUTHOR]

To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36–39.23, effect size 0.93) and area (95% CI 146–3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. NCT03359135 Compression garments immediately improve balance in people with hypermobile Ehlers-Danlos Syndrome (hEDS) Compression garments combined with regular physiotherapy improve balance in people with hEDS after 4 weeks of treatment Compression garments could compensate for proprioceptive impairment in hEDS [ABSTRACT FROM AUTHOR]

Eighty-year-old female physician sought consultation for continued use of Nisha-Amalaki (N-A), which had relieved her Nocturnal Leg Cramps (NLCs). She had well-controlled hypertension (HT) for 28 years and diabetes mellitus for 26 years, and experienced occasional NLCs since the age of 35 years without a need of any pharmacotherapy. For increased NLCs frequency and severity post diagnosis of diabetes, she recently started N-A (500 mg) once daily. She was already on metformin (500 mg) twice a day, glimepiride (0.5 mg) once a day, telmisartan (40mg) + hydrochlorothiazide (12.5 mg) once a day, and cilnidipine (5 mg) once a day, along with nutritional supplements (multivitamin, vitamin-B12, and calcium 500 mg once daily). HbA1c was maintained between 6-6.9% and fasting blood sugar (FBS) between 114-126 mg%. There was no Retinopathy (RP) or nephropathy (NP). Her NLCs almost disappeared in four weeks and she has now continued N-A for the last nine months. At this point, glimepiride 0.5 mg after dinner to reduce FBS and HbA1c, and aspirin 75 mg to improve microcirculation, were added. Most practicing physicians, as in this case, are satisfied if the HbA1c is maintained below 7% and hope to avoid the risk of hypoglycemia, which can also be harmful. Recent literature shows that RP, NP, and peripheral neuropathy (PN) start after HbA1c crosses 6% and may rise sharply after 8%. The purpose of this case report is to encourage a stricter control of HbA1c and highlight that NLCs could indicate early PN. [ABSTRACT FROM AUTHOR]

This study aims to assess the influence of lower body compression tights on performance in the Running-Based Anaerobic Sprint Test (RAST) in young male basketball players. Twenty male basketball players participated in the study (age = 16.5±0.5 years, height = 176.8±5.71 cm, weight = 68.5±8.98 kg, basketball experience = 2.35±0.49 years). Players performed the RAST, comprising 6 x 35 m sprints with 10-second intervals, wearing regular shorts or compression tights, with a one-week interval between conditions. Before each test, a 24-hour dietary record was used to calculate the total calorie intake and the percentage of calories from carbohydrates to account for dietary variations. The Hooper Index was used to assess fatigue levels before each test. The RAST, conducted using a Newtest Powertimer photocell (300 Series, Oulu, Finland), determined maximal power (Pmax), minimum power (Pmin), average power (AP), and fatigue index (FI). Perceived exertion after each RAST was assessed using the Borg Scale (20-point system). Paired-samples ttest results showed no statistically significant difference (p>0.05) between the means from the two test sessions. The study suggests that lower body compression tights did not significantly impact RAST performance in young basketball players. Considering the study design, applying it to more experienced players after familiarization sessions with compression tights may yield different results. [ABSTRACT FROM AUTHOR]

Introduction: Objective measurement of compliance is mandatory to evaluate therapeutic effects and clinical benefits of medical compression stockings. This Valitrack study evaluates the Accutrack sensor equipped with an accelerometer. The evaluation is done under controlled and free conditions and during washing. Results: Global accordance results are excellent: Sensitivity (98.6%) and specificity (95.2%) and 92% of patients are not disturbed by the sensors when putting on the stockings. Discussion: Thanks to its specificities one sensor per patient is sufficient. Its sensitivity distinguishes still and active positions. Only hand washing remains a false positive. The Accutrack sensor objectively measures compliance and will not be a bias because 96% of patients forget it. Conclusions: Objective compliance measurement with Accutrack allows us to evaluate the efficacity of compression, the reasons of non-compliance, and the patient's actual physical activity according to its accelerometer time-stamped. [ABSTRACT FROM AUTHOR]

The 11th annual National Lymphoedema Conference, organised by the British Journal of Community Nursing in association with the British Lymphology Society and Lipoedema UK, was hosted at the America Square Conference Centre, London, on 22 February 2024. The conference, which aims to provide new insights into the latests developments in lymphoedema care and management through talks by leading experts in the field, was attended by an impressive number of delegates and exhibitors. The sessions were Chaired by BLS Trustee Rebecca Elwell, and are summarised below. [ABSTRACT FROM AUTHOR]

Toe and foot swelling can manifest as lymphoedema or chronic oedema but can also be a complication of the treatment of these conditions. In this article, the authors discuss the assessment and treatment options for toe and foot swelling, highlighting the importance of prevention in the first instance. [ABSTRACT FROM AUTHOR]

Compression therapy (CT) in venous leg ulcer (VLU) treatment has been further investigated, obtaining such favourable results -- by improving chronic venous hypertension and enhancing other positive effects in its pathophysiology -- that it is currently the cornerstone of its treatment. However, leg ulcers (LU) of non-venous aetiology can also benefit from CT. To date, current contraindications for CT are minimal. Despite these benefits, only 50 - 60% of these patients receive CT as part of their treatment, resulting in lower healing rates than expected. Inelastic bandages (IB) and short-stretch bandage (SSB) have multiple benefits in LU and VLU treatment as they provide low resting pressures and high working pressures >60mmHg in standing and walking, improving venous haemodynamics. The aim of this narrative review was to describe the benefits of IB and SSB in the treatment of LU non venous etiology. We conducted a non-systematic review of literature guided by the Scale for the Quality Assessment of Narrative Articles (SANRA), regarding the benefits of IB and short-stretch bandage (SSB) CT systems in LU non venous etiology. IB are safety systems which can be useful in multiple LU aetiology, including chronic venous hypertension, diabetes, peripheral arterial disease (PAD) and inflammatory diseases, reducing pain, time for wound healing, oedema, exudate, inflammatory process, and sanitary costs. IB and SSB have benefits that other elastic materials are often unable to achieve and, when their knowledge and training are well established, they have been shown to improve LU patient care. [ABSTRACT FROM AUTHOR]

This systematic literature review was carried out by a final-year nursing student in response to clinical experience, and to understand the rationale and evidence around managing venous ulcers. In the student's clinical experience, the two most commonly used treatment methods were forms of compression hosiery and compression bandaging. The CINAHL, Science Direct, Cochrane Library, Internurse and MEDLINE databases were searched for literature published over the period 2003–2023. From the resulting five papers, five key themes were identified: types of compression systems used and the rationale for decision-making; clinical effectiveness; the impact on patient experience and quality of life; pain levels following application of compression systems; and cost effectiveness. Conclusion: Management and prevention of venous ulceration is complex. The decisions should be made in partnership with the patient and will be influenced by context. Overall, compression hosiery was identified as the more favourable system. [ABSTRACT FROM AUTHOR]

This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure. [ABSTRACT FROM AUTHOR]