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Snowdon N.J.1, Sier D.2, Potia T.1, Wheat J.3, McLean S.1
1Sheffield Hallam University, Faculty of Health and Wellbeing, Sheffield, United Kingdom, 2Rotherham, Doncaster and South Humber NHS Foundation Trust, Doncaster, United Kingdom, 3Sheffield Hallam University, Centre for Sports Engineering Research, Sheffield, United Kingdom
Background: Compression is thought to improve movement control and can be applied through compression garments and fabric orthoses. To date, there is little clinical research available but the large body of research with healthy populations may identify clinically relevant effects.
Purpose: This review aimed to reveal potential clinical uses by taking a broad view across all research, including sport. We mapped previous research, identified findings relevant to physiotherapy and highlighted areas for future research.
Methods: Searches of MEDLINE, Web of Science, EMBASE, PsychINFO, Sport Discuss, AMED and CINAHL from their inception to December 2015 were undertaken using keywords and subject headings. Eligible studies were of any design, with healthy and clinical populations, investigating compression garments and fabric orthoses on measures relevant to movement. Screening was performed by two reviewers. Extracted study characteristics included year, study design, participants, intervention, pressure exerted, comparison intervention, measures used and key findings. Studies were analysed in two stages. First, publication dates, study designs, interventions and participants were analysed. Second, the measures used and study findings were analysed. The first stage included conference abstracts; the second stage only studies available as full reports. As is usual for a mapping review, appraisal of studies was not performed.
Results: Two hundred and eighteen studies were found. Three main types of garments were studied: sports compression garments, neoprene joint supports and made-to-measure fabric orthoses. Each type of garment was used primarily with one specific population. Compression garments were investigated in healthy people for improving sport performance and recovery from exercise; joint supports were investigated in arthritic conditions for improving proprioception and other fabric orthosis research investigated a variety of variables, mainly in neurological conditions. Mechanistic research included the impact of compression on circulation, peripheral fatigue and muscle damage. The research into clinical populations used less robust research approaches. Research into fabric orthoses focussed more on their long-term use as an adjunct to therapy, rather than as an orthosis with a short-term impact on movement. Acceptability appeared important for people with neurological conditions but was rarely investigated with robust qualitative methods. Acceptability was poor in studies investigating whole body suits in children and better where sleeves and socks were tested in adults. Compression may benefit proprioception, control of stance, circulation and recovery from exercise but research investigating compression garments for sport performance was less positive.
Conclusion(s): There is potential for novel clinical applications. Systematic reviews are recommended into the impact of compression on exercise performance and proprioception. Priorities for primary research are to determine effectiveness in neurological and musculoskeletal disorders, and to explore novel clinical applications where circulation and muscle protection may be beneficial. Future research should describe interventions more clearly, including the pressure applied by the garment.
Implications: In clinical practice, therapists should appreciate that compression has potential to improve circulation, decrease peripheral fatigue and improve proprioception. For established clinical uses in musculoskeletal and neurological practice, acceptability and cost may be improved by using the full range of garments and orthoses available rather than those traditional in each field.
Funding acknowledgements: Funding provided by the Department of Allied Health Professions, Sheffield Hallam University.
Topic: Professional practice: other
Ethics approval: Ethical approval was not required for this review.
All authors, affiliations and abstracts have been published as submitted.
