The quality of evidence is downgraded by study limitations (lack of allocation concealment and blinding) and by imprecise results (few subjects and outcome events).
A Cochrane review [Abstract] 1 included 1 prospective cross-over study with 19 subjects. It measured the effect of no compression followed by 2 phases with different gradients of compression stockings on symptoms in female flight attendants who were required to stand, almost continuously, for long periods of time. The participants had mild venous disease including spider or varicose veins but no symptoms of chronic venous insufficiency (CVI). Wearing 8 to 15 mmHg compression stockings resulted in a significant improvement in leg symptoms. Individually, discomfort, aching and fatigue were improved with statistically significant effects (P < 0.001); swelling and tightness also improved but to a lesser although statistically significant degree (P < 0.01). The study demonstrated that wearing 15 to 20 mmHg compression stockings also improved symptoms in the leg although to a lesser extent. The heavier support stocking was most effective in reducing discomfort and aching (P < 0.01). Tightness and fatigue also showed a statistically significant improvement (P < 0.05) with the 15 to 20 mmHg stocking but swelling did not show any statistically significant improvement (P > 0.05). The study found no significant difference between the two compression stockings.
The study did not address any of the secondary outcomes including quality of life or economic impact of the interventions. No studies were found which measured the effectiveness of other non-pharmacological interventions or strategies aimed at preventing CVI in standing workers.
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