title: Impact of variation in limb shape on sub-bandage interface pressure.
abstract: BACKGROUND
  Sub-bandage interface pressure generated by medical compression bandages (MCB) and hosiery changes in mobile patients as they move due to the change in the limb size. However, the amount of variation in the interface pressure is dependent on the stiffness of the compression material. Researchers have proposed several indices to describe this change in interface pressure, including the static stiffness index (SSI) and the dynamic stiffness index (DSI). These indices can also be used to classify compression products.
  
  
  OBJECTIVE
  To explore the different proposed indices to describe the stiffness of a compression material and compare it to the engineering stress-strain modulus which is used for the same purpose; To estimate theoretically the change in the interface pressure which is caused by the change in the limb shape as a consequence of calf muscle activity and the associated transient variation in limb dimensions.
  
  
  METHODS
  Use Chord modulus to classify compression material; Use thin and thick cylinder wall theory to estimate the variation in the interface pressure due to changes in the limb shape secondary to muscle contraction; Use tensile test devices to obtain the Chord modulus for two different MCB at two different dynamic ranges.
  
  
  RESULTS
  Chord modulus (E) describes the change in tension in a dynamic situation, and this is labelled as stiffness in the bandaging literature; Chord modulus, with the help of a mathematical model that was developed based on thick wall cylinder theory, can be used to predict the change in sub-bandage interface pressure caused by the change in limb shape secondary to calf muscle activity; Chord modulus can be used to classify bandages and describe how they will behave when they are applied to a leg.
  
  
  CONCLUSIONS
  The dynamic pressure can be predicted using a simple mathematical model using Chord modulus, which can be calculated in vitro using standard tensile testing equipment. In addition, Chord modulus can be used to classify compression bandages and hosiery.
authors.affiliation: University of Leeds-Mechanical Engineering, WoodHouse Lane, Leeds Ls29JT, UK. efy3jaa@leeds.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Al Khaburi
authors.forename: E A
authors.initials: EA
authors.lastname: Nelson
authors.forename: J
authors.initials: J
authors.lastname: Hutchinson
authors.forename: A A
authors.initials: AA
authors.lastname: Dehghani-Sanij
mesh_terms: D000818:Animals; D058128:Compression Bandages; D005121:Extremities / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008962:Models, Theoretical; D009929:Organ Size; D011312:Pressure; D013312:Stress, Physiological