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International Angiology 2020 April;39(2):155-60

DOI: 10.23736/S0392-9590.20.04223-6


language: English

Effects of elastic stockings on peripheral and central nervous system

Stefano MANCINI 1, Fabrizio MARIANI 2, Alessandro ROSSI 3, David CIONCOLONI 4, Federica GINANNESCHI 3

1 Unit of Phlebolymphology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy; 2 European Training Center in Phlebology - European Union of Medical Specialists, Angiomedica Vein Clinic, Colle Val d’Elsa, Siena, Italy; 3 Section of Neurology and Clinical Neurophysiology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy; 4 Unit of Rehabilitation, University Hospital of Siena, Siena, Italy

BACKGROUND: Prospective study to investigate the effects of elastic stockings (GCS) 23-32 mmHg at ankle on Hoffmann reflex (H-reflex) from soleus muscle under rest and after a walking program.
METHODS: Fourteen subjects wore two types of GCS, at different times. Electrophysiological examinations were carried out at rest without and with GCS, immediately after walking with GCS and 20 minutes later after removing GCS.
RESULTS: Peripheral nerve conduction remained unchanged after using the GCS. Conversely, walking with GCS led to changes in a spinal cord pathway expressed as a decrease of H-threshold and an increase of H-size as a function of stimulus intensity, which lasted for at least 20 minutes.
CONCLUSIONS: GCS has no effect on the peripheral nervous system. The GCS intolerance and the discomfort sometimes reported by patients do not derive from a dysfunction of the lower limb peripheral nervous system. A positive action on spinal reflex excitability is detected after walking while wearing GCS. We suggest that nervous descending activity due to voluntary contractions, and afferent cutaneous discharge, enhanced by movement under compression, converge on inhibitory interneurons, thus impinging on presynaptic pathways. All this can lead to an enhancement of the monosynaptic responses. Higher limb oxygenation detected during walking with GCS, found by other Authors, could increase the sensitivity of the muscle spindle afferents and/or motor neuron excitability resulting in an increase in H-reflex excitability, with potential positive effects on neuromuscular activities improving proprioception and postural control of the lower limbs.

KEY WORDS: Compression stockings; Central nervous system; Peripheral nervous system; H-reflex; Patient compliance

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