A randomised crossover study of low-ankle-pressure graduated-compression tights in reducing flight-induced ankle oedema

Melissa J Hagan and Stephen M Lambert
Med J Aust 2008; 188 (2): 81-84.


Objective: To determine if low-ankle-pressure graduated-compression tights (GCTs) reduce flight-induced ankle oedema and subjectively rated travel symptoms of leg pain, discomfort and swelling, and improve energy levels, ability to concentrate, alertness, and post-flight sleep.

Design, setting and participants: Open, randomised crossover trial comparing the effects of GCTs (5 mmHg at ankle, 17–20 mmHg at calf and falling to 10 mmHg above knee and 4 mmHg at buttocks) among 50 adults on flights of 5 hours’ or more duration between 1 May and 8 October 2006; 47 volunteers (pilots and passengers) completed the trial.

Main outcome measures: Differences in right ankle circumference before and after flight with GCTs and without GCTs; travel symptoms rated on visual analogue scales.

Results: Low-ankle-pressure GCTs decreased ankle swelling (mean difference, 0.19 cm; 95% CI, 0.33 to 0.65 cm; P = 0.012). Participants reported their legs felt better (mean, 1.6; P < 0.001; 95% CI, 1.0 to 2.1), warmer (mean, 1.1; P < 0.001; 95% CI, 1.6 to 0.6), and they had a better night’s sleep (mean, 1.2; P < 0.001; 95% CI, 0.8 to 1.7) after the flight when they wore GCTs. Shifts in rating-scale probability distributions showed improvements in the ratings of pain (60%; P < 0.001), leg discomfort (50%; P = 0.001), leg swelling (45%; P = 0.006), energy levels (18%; P = 0.016), alertness levels (13%; P = 0.031), and concentration (12%; P = 0.023) when wearing GCTs.

Conclusions: Low-ankle-pressure GCTs reduce flight-induced ankle oedema and subjectively rated travel symptoms of leg pain, discomfort and swelling, and improve energy levels, ability to concentrate, alertness, and post-flight sleep.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12606000150549.

  • Melissa J Hagan1
  • Stephen M Lambert2

  • 1 MPro, Brisbane, QLD.
  • 2 The University Clinic, Westmead Hospital, Sydney, NSW.


Competing interests:

Funding for this study was provided by Skins Compression Garments of Sydney, NSW. Melissa Hagan was contracted to conduct the study independently, and received no other funding from the company other than to conduct this research. Stephen Lambert is under contract as a scientific consultant for Skins Compression Garments. The study was initially designed by Stephen Lambert. Melissa Hagan independently collected, analysed and interpreted the data, and wrote the article. The agreement to publish the results was made prior to data collection with the Bellberry Human Research Ethics Committee, which approved this study. Skins Compression Garments had no influence over the decision to publish, and Melissa Hagan had final approval over the article’s content. The trial was registered with the Australian Clinical Trials Registry (trial no. 12606000150549) and was initiated on 19 April 2006.

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