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  • Writer's picturePursuit of Motion Physiotherapists

Do air compression leg sleeves work?

Updated: Dec 4, 2023



What are these weird-looking space boots?


Intermittent Pneumatic Compression (IPC) is a form of compression therapy in which a sleeve is worn on the target limb and compression is provided to different portions of the sleeve (Heapy et al., 2018).


IPC is popular among endurance athletes as it is believed that this form of therapy will aid the recovery process after bouts of intensive exercise (Stedge & Armstrong, 2021). IPC is also used to treat other medical conditions including venous leg ulcers and limb swelling (Nelson, Hillman, & Thomas, 2014). Compression therapy is also used to prevent blood clots and venous thromboembolisms (Nelson et al., 2014).


There are many different brands of IPC devices that are commercially available and used in many different settings such as hospitals and physiotherapy clinics. Some popular brands of IPC devices include NormaTec and Air Relax.



Does the research support the hype train?


Leg Ulcers

A systematic review by Nelson et al. (2014) looked at the effectiveness of IPC for treating venous leg ulcers. This study looked at nine randomized controlled trials with a total of 489 participants.


One trial found that IPC is more effective at healing leg ulcers than compressive bandages alone, but Nelson et al. (2014) note that this trial was of poor quality. Five trials in this review compared IPC to continuous compression and two of these trials found that IPC healed ulcers better than continuous compression while the other three trials found no statistically significant difference between the IPC group and the continuous compression group. One trial also reported that rapid IPC was more effective at healing ulcers than slow IPC.


Nelson et al. (2014) state that more trials are required to understand the effectiveness of IPC at treating venous leg ulcers


A comparative clinical study by Dolibog et al. (2014) compared the effectiveness of five different types of compression therapy at treating venous leg ulcers. The five types of compression therapy studied were: IPC, ulcer stocking system Ulcer X, multi-layer short stretch bandaging, two layer short stretch bandaging, and Unna’s boot.


The authors reported that IPC, stockings, and multi-layer bandages were the most effective at treating venous leg ulcers.


The authors note that further trials are needed to assess the cost-effectiveness of different compression therapies and to examine larger sample sizes (Dolibog et al., 2014).



Venous Thromboembolism

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are complications that can happen after someone undergoes surgery (Zhao et al., 2014).


One systematic review looked at the effectiveness of IPC at preventing venous thromboembolism in patients who underwent a total hip replacement (Zhao et al., 2014). Only one study met the inclusion criteria for this review which involved 121 participants. The one study included in this review reported no cases of DVT or PE during three weeks following total hip replacement surgery.


However, the authors state the results of the systematic review are inconclusive due to the lack of randomized controlled trials (Zhao et al., 2014). More research is needed to identify suitable clinical recommendations.


A more recent randomized controlled trial by Lobastov et al. (2021) looked at the effectiveness of IPC as a form of prophylactic treatment in high-risk patients. 407 participants were divided into an IPC group and a control group.


The authors identified that participants with a score of 11 or greater on the Caprini scale for venous thromboembolism who received adjunct prophylactic IPC reported a lower incidence of thromboembolism when compared to standard prophylaxis (Lobastov et al., 2021).


However, the authors noted several limitations to the study including lack of placebo, high variability of surgical procedures, and confounding factors such as early ambulation that may have contributed to the decrease in Caprini score (Lobastov et al., 2021).



Athlete Recovery

Considering how popular IPC is among athletes it was surprising to find that there is not a lot of research on the effects of IPC for athletic populations.


Stedge & Armstrong (2021) critically appraised the use of IPC for high-level endurance athletes and concluded that IPC may result in immediate relief of delayed onset muscle soreness (DOMS) but it has no long-term effect on exercise-induced muscle damage (EIMD).


Their appraisal looked at three studies, including two randomized controlled trials and one randomized crossover study, and all three studies found no statistical difference between IPC and a control group (Stedge & Armstrong, 2021).


Two of the studies did report that IPC led to immediate relief of soreness, but found no differences in long-term relief of EIMD (Stedge & Armstrong, 2021). The authors noted several limitations to their critical appraisal including differing parameters in all three studies, different brands of IPC devices, and the use of different outcome measures to assess the results of the study (Stedge & Armstrong, 2021).


A randomized controlled trial by Heapy et al. (2018) looked at the effectiveness of IPC for recovery of long-distance runners. 61 participants were included in this study and were divided into an IPC group, a massage group, and a control group.


Both, the massage and IPC group reported immediate improvement in muscle fatigue and soreness, but failed to find any long-term benefits after four consecutive days of treatment post-marathon (Heapy et al., 2018).


 

References:


Dolibog, P., Franek, A., Taradaj, J., Dolibog, P., Blaszczak, E., Polak, A., Brzezinska-Wcislo, L., Hrycek, A., Urbanek, T., Ziaja, J., & Kolanko, M. (2013). A comparative clinical study on five types of compression therapy in patients with venous leg ulcers. International journal of medical sciences, 11(1), 34–43. https://doi.org/10.7150/ijms.7548


Heapy, A. M., Hoffman, M. D., Verhagen, H. H., Thompson, S. W., Dhamija, P., Sandford, F. J., & Cooper, M. C. (2018). A randomized controlled trial of manual therapy and pneumatic compression for recovery from prolonged running - an extended study. Research in Sports Medicine, 26(3), 354–364. https://doi-org.login.ezproxy.library.ualberta.ca/10.1080/15438627.2018.1447469


Lobastov, K., Sautina, E., Alencheva, E., Bargandzhiya, A., Schastlivtsev, I., Barinov, V., Laberko, L., Rodoman, G., & Boyarintsev, V. (2021). Intermittent Pneumatic Compression in Addition to Standard Prophylaxis of Postoperative Venous Thromboembolism in Extremely High-risk Patients (IPC SUPER): A Randomized Controlled Trial. Annals of surgery, 274(1), 63–69. https://doi.org/10.1097/SLA.0000000000004556


Nelson, E. A., Hillman, A., & Thomas, K. (2014). Intermittent pneumatic compression for treating venous leg ulcers. The Cochrane database of systematic reviews, (5), CD001899. https://doi.org/10.1002/14651858.CD001899.pub4


Stedge, H. L., & Armstrong, K. (2021). The Effects of Intermittent Pneumatic Compression on the Reduction of Exercise-Induced Muscle Damage in Endurance Athletes: A Critically Appraised Topic. JOURNAL OF SPORT REHABILITATION, 30(4), 668–671. https://doi-org.login.ezproxy.library.ualberta.ca/10.1123/jsr.2020-0364


Zhao, J. M., He, M. L., Xiao, Z. M., Li, T. S., Wu, H., & Jiang, H. (2014). Different types of intermittent pneumatic compression devices for preventing venous thromboembolism in patients after total hip replacement. The Cochrane database of systematic reviews, 2014(12), CD009543. https://doi.org/10.1002/14651858.CD009543.pub3

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