Clothing pressure analysis of commercial women's leggings for applying medical compression classes
Fashion and Textiles volume 10, Article number: 8 (2023)
The high-elasticity bottoms applying gradual pressurization to the blood vessels of the lower extremities simultaneously assisting to both prevention and treatment of multiple health conditions such as varicose veins. Medical compression stockings are classified as medical supplies, and there is a clear standard on magnitude and application for gradual pressure. However, in the case of leggings, there are no relevant experimental data or papers supporting these findings. This study was performed in order to analyse the gradual compression values in legging. Eight types of leggings currently available on the market by different brands, were analysed to determine the type of pressure applied. The pressure was measured at five points of the clothed body with leggings pulled across lower extremities. An airpack sensor was attached to a wooden leg model and five consecutive records at each measuring point were taken. Afterwards the average values were calculated. As observed in all eight leggings, the measuring point with the highest pressure applied was the back of the calf (mean 18.25 mmHg) or the below the knee circumference (mean 13.83 mmHg), pointing to deviance in applying gradual pressure as proposed in medical compression stockings. The commercial leggings used in this experiment did not show a gradual increase in pressure from the thigh to the ankle body zone. One can presume that the legs’ fatigue would increase over the time. Since, the gradual pressure should be applied in legging construction as seen in medical compression stockings.
Compression wear is designed to be worn in close contact with the body. It should be characterized by elasticity, excellent wearing comfort and lightness. Those attributes are usually achieved by spinning yarns of special functional properties in order to produce the functional compression wear, which will improve self-confidence, exercise ability, athletic performance, blood circulation, energy, physical recovery and reduced muscle fatigue (Watson and Rorke, 2016). In sports sciences, studies on the effects of compression wear indicate that venous pressure decreases when exercising with compression stockings or tights, thus increasing venous blood flow (Miyamoto & Kawakami, 2015; Norris et al., 1984; Partsch & Mosti, 2013). After exercise, muscle damage is reduced, and muscle tremors, vibrations, and pain are reduced to improve the exercise effect (Ali et al., 2007; Bieuzen et al., 2014; Ferguson et al., 2014; Hill et al., 2014). Unlike stockings, leggings are on the rise because of expectations that the lower body will be tightened under constant pressure to compensate for the body shape. However, unlike medical compression stockings, general leggings are not designed with the clothing pressure applied to each body part in mind. Therefore, if leggings are constructed to place constant pressure to every part of the lower extremities, without gradual increase in pressure value, they can interfere with the blood flow from the ankles to the thighs. Diseases such as varicose veins, for example, are particularly common among women. Compression stockings are often the first line of treatment and come in a variety of lengtThs and apply different pressures to support the flow of blood in the veins (Knight, 2021; Yvette, 2017). Medical compression stockings are effective in treating varicose veins by reducing or closing the diameter of the lower extremities or deep vein to prevent blood reflux (Partsch & Partsch, 2005; Partsch et al., 2002; Sarin et al., 1992), and depending on the symptoms, physician can prescribe medical compression stockings by adjusting the stiffness.
Clothing pressure is pressure provided by the clothing in close contact to a body part. Clothing pressure affects the physiological functions of the human body depending on the degree of pressure on it. Clothing pressure with appropriate levels of pressure on the human body improves the wearing sensation of the garment and facilitates physical activity (Mosti, 2012; Partsch et al., 2012; Shim & Choi, 1991). Excessive clothing pressure, however, gradually decreases blood flow and causes muscle fatigue and blood flow disorders (Tanaka et al., 2006). As such, even if the bodily motor-function are improved by compression garment worn over the body, constructing the functional compression clothing items with improper pressure value distribute across the body may cause more harm than health benefit. Therefore, the women exercise leggings should be designed by applying gradual pressure over the lower limbs in order to achieve characteristics similar to medical compression stockings.
Some countries, such as the United States, Europe, the United Kingdom, Germany, and France, have standards for pressure classes for medical compression stockings (Do & Kim, 2013; Iwama et al., 2000; Macrae et al., 2011). The standard for medical compression stockings defines how they are classified, based on which compression stockings are manufactured. In addition, the European Committee for Standardization (ENV, 12718:2001, 2001) stated that the intensity of pressure on each leg area is based on the pressure on the ankle circumference. Medical compression stockings are manufactured by using pressure-class criteria to anticipate therapeutic effectiveness and performance in production. However, compression wear such as leggings differ from medical compression stockings in terms of the target audience, purpose of wearing, and expected product functions. Therefore, it may be difficult to apply the pressure class of medical compression stockings to compression leggings.
Previous studies related to leggings are limited to design and pattern development (Gozde & Sinem, 2019; Hwang & Choi, 2014; Pettys-Baker et al., 2017). In addition, most of the studies of compression bottoms are also related to exercise performance (Bringard et al., 2006; Hill et al., 2014; Liu & Little, 2009; Perrey et al., 2008; Rugg & Sternlicht, 2013) and physical recovery (Duffield and Portus, 2007; Trenell et al., 2006) when wearing shorts pants. There is a lack of research on pressure provided by the clothing in close contact to a body part, especially when considering athleisure leggings that cover the entire lower extremities from the waist to the ankle. Therefore, this study aims to provide basic data for the development and sizing system of gradual compression leggings by measuring the value and distribution of clothing pressure applied over the lower extremities.
In this study, commercial leggings were measured using eight different samples from Korean Athleisure wear brands (Fig. 1). These leggings have the fewest incisions and are the medium-sized product with a basic design made by seamless sewing. The brands were sorted alphabetically and named A–H. The size cords were different for each product, such as 'M', '4', and '6'. The fiber composition indicated for the product consisted of nylon or polyester and stretch material. The content of functional stretch fibers was different for each product, and stretch fibers such as 'Spandex', 'Polyurethane', and 'Lycra' were used. The number of pattern panels of the leggings ranged from five to eleven (Table 1). In the West, such as the United States, Europe, the United Kingdom, Germany, and France, criteria for clothing pressure have been established. However, in the case of Asia, it is necessary to study for this because the criteria setting for clothing pressure is insufficient. In addition, since the dummy used to measure clothing pressure in this study was a Korean women’s leg dummy (Korea Patent No.10, 1524019-0000, 2015) produced based on Size Korea’s anthropometric data (Korean Agency for Technology & Standards, 2010), only Korean leggings brands excluding global brands were selected among the top sales rankings, which could lead to further research on Asian body types.
Measurement of leggings size
In order to analyze the product, this study investigated the sizing system presented on the product-sales website of each of the commercial leggings. To compare the actual size of each brand, leggings were measured. Size measurement items are a total of 13 items: ‘Outseam length’, ‘Waist circumference’, ‘Hip circumference’, ‘Thigh circumference’, ‘Knee circumference’, ‘Ankle circumference’, ‘Front crotch length’, ‘Back crotch length’, ‘Front crotch length (at top edge waistband)’, ‘Back crotch length (at top edge waistband)’, ‘Waistband front length’, ‘Waistband side length’, and ‘Waistband back length’ (Table 2).
Measurement of leggings pressure
The Korean adult-female leg model was employed (Do & Kim, 2015) to measure the dimensions of compression stockings and the clothing pressure of commercial leggings. Figure 2 shows the air-pressure sensor attached to the leg model and wearing leggings. For the selection and measurement method of clothing pressure measurement sites were referred to previous studies (Do & Kim, 2013; Itouh, 1999).
Five points were defined as the endpoints of the gastrocnemius muscle (b1), back side of the calf (c), back side below the knee girth (d), back side of the mid-thigh girth (f), and back side of the thigh girth (g) (Table 3). AMI-3037 (AMI Techno Co., Ltd, Japan), which is an air-injection-type clothing pressure sensor, was used to measure the clothing pressure (Table 4). The experimental environment was in an artificial climate room with an ambient temperature of 23 °C and a humidity of 65% RH. Subsequently, the clothing pressure was recorded five times per minute, and the average value was calculated from the collected data, excluding the unstable first 10 s.
Leggings sizing system survey by brand
By examining the sizing system of leggings based on the product information shown on each website of commercial leggings, it was found that the leggings brands measured the actual size of each product in “cm.” The dimensioning method for the leggings brands was Brands A, F, G, and H in letter types (XS, S, M, L…), and Brands B and E in numeric types (0,2,4,6…, 44, 55, 66, 77…). Brand C displayed both letter and numeric types, and Brand D did not adopt a special notation method as the free size; hence the notation method was different for each brand (Table 5). In addition, the website did not provide basic body data, such as stature, weight, and detailed sizes, which are usually provided by other clothing websites, but only the sizes of the circumference and width of the product. Even within the same size, the size provided by each brand or design of leggings is different; so if one does not know the exact size of the leggings that fits one’s body size when purchasing leggings, there may be a problem in purchasing the product with the correct fit.
Leggings product size measurement
In the measurement guide presented by each brand, the measurements were presented differently, even though the measurement locations and the product sizes were the same for each item. The actual size measurement indicated that the length of the leggings combined with the waistband and outseam lengths of Brand E was the shortest (84.0 cm), and that the longest was that of Brand D (92.0 cm). The waist circumference had the largest deviation, of 9.0 cm, from a minimum of 23.0 cm to a maximum of 32.0 cm. The hip circumference ranged from 32.5 to 39.5 cm, and the thigh circumference ranged from 20.3 to 22.5 cm. In the front, crotch length was the longest with Brand H at 15.0 cm, and the shortest was Brand F, at 10.8 cm. In the back, crotch length was the longest for Brand D, at 27 cm, and the shortest was Brand B, at 18.5 cm. The difference between the crotch front length and the crotch back length was the largest difference, with Brand D at 15.5 cm, and the smallest difference was with Brand B, at 5.0 cm. For the waistband, Brand A had a constant band length of 13.0 cm from the front, side, and back of the waistband. Brand H had the greatest width at the front and back of the waistband at 14.0 cm and 15.0 cm, respectively. The front and side of the waistband of Brand B were the shortest, at 9.0 cm and 9.5 cm, respectively, whereas Brands D, E, and F had a waistband shorter in the back than in the front (Table 6). In all brands, the stature dimensions were not reflected in the sale of the product, and online product sales website presented the length of leggings only with the category of the total length, which was the same as the sum of the waistband length and the outseam length. As such, even within the same size, it will be difficult for consumers to select the right size when purchasing leggings, because the size and deviations of products for each brand are not the same.
Garment-pressure measurement of leggings
By measuring the clothing pressure of the commercial leggings analyzed in this study, it was found that five products of Brands A, C, D, G, and H exhibited the highest clothing pressure at measuring point c (back side of calf), and that three products of Brands B, E, and F exhibited the highest clothing pressure at measuring point d (back side below the knee girth). According to the measurement results (Table 7), the clothing pressure in point b1 (endpoint of the gastrocnemius muscle) was distributed at 11.62–15.38 mmHg, and was the highest in Brand H. On the other hand, the clothing pressure of point d was distributed at 17.35–9.47 mmHg, and was the highest in Brand E and F. In addition, point c had the largest deviation of clothing pressure between brands at 22.22 mmHg and point f at 3.80 mmHg, the smallest deviation.
By examining the flow of the clothing pressure by the measurement region, it was found that the clothing pressure of Brand A decreased in the order of measuring points c > f > g > b1 > d, that of Brand B decreased in the order of measuring points d > c > b1 > f > g, that of Brand C decreased in the order of measuring points c > g > d > f > b1, that of Brand D decreased in the order of measuring points c > d > b1 > f > g, that of Brand E decreased in the order of measuring points d > c > b1 > f > g, that of Brand F decreased in the order of measuring points d > f > c > b1 > g, that of Brand G decreased in the order of measuring points c > b1 > f > d > g, and that of Brand H decreased in the order of measuring points c > b1 > d > g > f (Fig. 3). In addition, according to the European prestandard pressure classes for medical compression hosiery ENV 12718:2001 (2001) in the graph shown Fig. 3, indicates pressure that increases gradually from the thigh to the ankle region. However, the graphs of the commercial leggings products investigated in this study did not show the incremental pressure and did not achieve graduated pressure for each body part.
For medical compression stockings, products are designed based on pressure standards set as ‘very strong’, ‘strong’, ‘medium’, ‘light’ based on European compression standards (ENV, 12718:2001, 2001). However, compression wear such as leggings will have difficulties in applying the pressure standards, because the material, wearing time, wearing purpose, cutting the pattern, and sewing methods are different from those of medical compression stockings. By comparing the actual size of the product measured earlier with the clothing pressure of each body part, it was found that the pressure was higher in the product with a circumference smaller than the length. That means, in point b1, Brand H with the smallest ankle circumference was 15.38 mmHg, which had the highest clothing pressure. This pressure level corresponds to the ‘light’ level based on European compression standards, and by finding the dimension for the pressure and apply it to pattern development in a way that reduces the ankle circumference, the pressure can be set to be gradually lowered from ankle to thigh. Therefore, in order to set the pressure level for each body part for the graduated pressure design of leggings, it is considered necessary to first set the sizing system and pattern design of leggings.
In this study was investigated the clothing pressure of athletic wear leggings currently on the Korean market to acquire basic data for setting pressure standards and grades of leggings suitable for the different body types of Korean women. The results of this study are as follows. For commercial leggings, even if the size name was marked with the same title, there were many differences in product dimensions according to measurement items for each brand. Most of the items presented on the product sales website were circumferential, and only the ‘total length (the sum of the waistband length and the outseam length)’ and ‘crotch length’ of the product were presented for length items, it is difficult for consumers to select the size when purchasing leggings. By measuring the clothing pressure for each part of the lower extremity, it was found that the commercial leggings exhibited the highest clothing pressure of 18.25 mmHg and 13.83 mmHg at measuring point c (back side of the calf) or d (back side below the knee girth), respectively, there was no gradual compression based on the ankle region. In addition, the clothing pressure was influenced more by circumference than by length, and the clothing pressure for each part of the product with a relatively small circumference was relatively higher. It will be difficult for consumers to purchase products suitable for the body, because the dimensions provided by the companies are different for each product and design. Therefore, to improve the physiological function and comfort of compression wear, the development of a pattern designed for clothing pressure by graduated compression for each part of the lower extremity is necessary. As a follow-up study, to develop a pattern of leggings tailored to the clothing pressure standards of medical compression stockings (“strong,” “medium,” and “light”) by changing the ankle circumference using the relationship between the circumference and clothing pressure of the product identified in this study. And although there was no difference in clothing pressure according to the material mixing ratio in this study, it is considered necessary to compare the difference in pressure according to the material elongation rate in relation to the cutting method of the pattern.
Availability of data and materials
Ali, A., Carine, M. P., & Snow, B. G. (2007). Graduated compression stockings; Physiological and perceptual response during and after exercise. Journal of Sports Sciences, 25(4), 413–419. https://doi.org/10.1080/02640410600718376
Bieuzen, F., Brisswalter, J., Easthope, C., Vercruyssen, F., Bernard, T., & Hausswirth, C. (2014). Effect of wearing compression stockings on recovery after mild exercise-induced muscle damage. International Journal of Sports Physiology and Performance, 9(2), 256–264. https://doi.org/10.1123/IJSPP.2013-0126
Bringard, A., Perrey, S., & Belluye, N. (2006). Aerobic energy cost and sensation response during submaximal running exercise- positive effects of wearing compression tights. International Journal of Sports Medicine, 27, 373–378. https://doi.org/10.1055/s-2005-865718
Do, W. H., & Kim, N. S. (2013). The comparison on the compression measurement value of medical compression stockings. Journal of the Korean Society of Clothing and Textiles, 37(8), 1060–1074. https://doi.org/10.5850/JKSCT.2013.37.8.1060
Do, W. H. & Kim, N. S. (2015). Leg model for standard pressure setting and measurement of medical compression stocking. Korea Patent. No.10–1524019–0000. Korean Intellectual Property Office, Daejeon.
Duffield, R., & Portus, M. (2007). Comparison of three types of full-body compression garments on throwing and repeat-sprint performance in cricket players. British journal of sports medicine, 41(7), 409–414. https://doi.org/10.1136/bjsm.2006.033753
ENV 12718:2001. (2001). Medical compression hosiery (ENV 12718:2001). Comité Européen de Normalisation.
Ferguson, R. A., Dodd, M. J., & Paley, V. R. (2014). Neuromuscular electrical stimulation via the peroneal nerve is superior to graduated compression socks in reducing perceived muscle soreness following intense intermittent endurance exercise. European Journal of Applied Physiology, 114(10), 2223–2232. https://doi.org/10.1007/s00421-014-2943-5
Gozde, G. B., & Sinem, K. (2019). Design of novel running leggings with thermoplastic polyurethane membrane compression zones. Textile Research Journal, 89(8), 1533–1545. https://doi.org/10.1177/0040517518775911
Hill, J., Howatson, G., van Someren, K., Ken, A., Walshe, I., & Pedlar, C. R. (2014). Compression garments and recovery from exercise-induced muscle damage: A meta-analysis. British Journal of Sports Medicine, 48(18), 1340–1346. https://doi.org/10.1136/bjsports-2013-092456
Hwang, Y. J., & Choi, J. H. (2014). A study on formative characteristics of the leggings design in contemporary fashion. Fashion & Textiles Research Journal, 16(1), 1–12. https://doi.org/10.5805/SFTI.2014.16.1.1
Itouh, N. (1999). 衣服圧および接触圧測定法[Clothing pressure and contact pressure measurement]. Journal of the Japan Research Association for Textile End-Uses, 40(12), 781–786. https://doi.org/10.11419/senshoshi1960.40.781
Iwama, H., Suzuki, M., Hojo, M., Kaneda, M., & Akutsu, I. (2000). Intermittent pneumatic compression on the calf improves peripheral circulation of the leg. Journal of Critical Care, 15(1), 18–21. https://doi.org/10.1053/jcrc.2000.0150018
Knight (nee Shingler), S. L., Robertson, L. and Stewart, M. (2021). Graduated compression stockings for the initial treatment of varicose veins in people venous ulceration. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD008819.pub4
Korean Agency for Technology and Standards. (2010). The 6th Size Korea 3D scan & measurement technology report. Government Printing Office.
Liu, R., & Little, T. (2009). The 5Ps model to optimize compression athletic wear comfort in sports. Journal of Fiber Bioengineering and Informatics, 2, 41–52. https://doi.org/10.3993/jfbi06200907
Macrae, B. A., Cotter, J. D., & Laing, R. M. (2011). Compression garments and exercise garment considerations, physiology and performance. Sports Medicine, 41(10), 815–843. https://doi.org/10.2165/11591420-000000000-00000
Miyamoto, N., & Kawakami, Y. (2015). No graduated pressure profile in compression stockings still reduces muscle fatigue. International Journal of Sports Medicine, 36(3), 220–225. https://doi.org/10.1055/s-0034-1390495
Mosti, G., Labichella, M. L., & Partsch, H. (2012). Compression therapy in mixed ulcers increases venous output and arterial perfusion. Journal of Vascular Surgery, 55(1), 122–128. https://doi.org/10.1016/j.jvs.2011.07.071
Norris, G. S., Turly, S. G., & Barnes, R. W. (1984). Noninvasive quantification of ambulatory venous hemodynamics during elastic therapy. Angiology, 35(9), 560–567. https://doi.org/10.1177/000331978403500903
Partsch, H., Mosti, G., & Uhl, J. F. (2012). Unexpected venous diameter reduction by compression stocking of deep, but not of superficial veins. Veins and Lymphatics, 1(1), 7–9. https://doi.org/10.4081/vl.2012.e3
Partsch, H., & Mosti, G. (2013). Sport socks do not enhance calf muscle pump function but inelastic wraps do. A Journal of the International Union of Angiology, 33(6), 511–517.
Partsch, B., & Partsch, H. (2005). Calf compression pressure required to achieve venous closure from supine to standing position. Journal of Vascular Surgery, 24(4), 734–738. https://doi.org/10.1016/j.jvs.2005.06.030
Partsch, H., Menzinger, G., Borst-Krafek, B., & Groiss, E. (2002). Does thigh compression improve venous hemodynamics in chronic venous insufficiency? Journal of Vascular Surgery, 36(5), 948–952. https://doi.org/10.1067/mva.2002.127343
Sarin, S., Scurr, J. H., & Smith, C. (1992). Mechanism of action of external compression on venous function. British Journal of Surgery, 79(6), 499–502. https://doi.org/10.1002/bjs.1800790608
Perrey, S., Bringard, A., Racinais, S., Puchaux, K., Belluye, N., & Estivalet, M. (2008). Graduated Compression Stockings and Delayed Onset Muscle Soreness (P105). The Engineering of Sport, 7(1), 547–557. https://doi.org/10.1007/978-2-287-09411-8_64
Pettys-Baker, R., Compton, C., Utset-Ward, S., Tompkins, M., Holschuh, B. & Dunne, L. E. (2017). Design and development of valgus-sensing leggings. In: Paper presented at the American Society of Mechanical Engineers Digital Collection. https://doi.org/10.1115/DMD2017-3526. https://asmedigitalcollection.asme.org/BIOMED/proceedings/DMD2017/40672/V001T05A017/229425. Accessed 20 Oct 2018
Rugg, S., & Sternlicht, E. (2013). The effect of graduated compression tights, compared with running shorts, on counter movement jump performance before and after submaximal running. Journal of Strength and Conditioning Research, 27(4), 1067–1073. https://doi.org/10.1519/JSC.0b013e3182610956
Shim, B. J., & Choi, S. H. (1991). Studies on garment restraint (I)-Change of skin temperature by continuous restraint method. Journal of the Korean Home Economics, 29(1), 13–25.
Tanaka, S., Midorikawa, T., & Tokura, H. (2006). Effects of pressure exerted on the skin by elastic cord on the core temperature, body weight loss and salivary secretion rate at 35°C. European Journal of Applied Physiology, 96, 471–476. https://doi.org/10.1007/s00421-005-0099-z
Yvette, B. (2017). What can I do about varicose veins?. Available at: https://www.medicalnewstoday.com/articles/240129#symptoms. Accessed 16 June 2021.
Trenell, M. I., Rooney, K. B., Sue, C. M., & Thomspon, C. H. (2006). Compression garments and recovery from eccentric exercise: a 31P-MRS Study. Journal of sports science & medicine, 5(1), 106–114
Watson, B., & Rorke, S. (2016). Are compressiong garments beneficial for endurance runners? ACSM’s Health & Fitness journal, 20(2), 12–18. https://doi.org/10.1249/FIT.0000000000000190
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Lee, J., Do, W. Clothing pressure analysis of commercial women's leggings for applying medical compression classes. Fash Text 10, 8 (2023). https://doi.org/10.1186/s40691-022-00324-6
- Compression leggings
- Clothing pressure
- Applying gradual pressure
- Lower extremities
- Women’s leggings