The Effects of Graduated Compression Sleeves on Muscle Performance: A Randomised Controlled Trial

Abstract

The purpose of this study was to examine the effects of graduated compression sleeves on muscle performance during high-intensity exercise. Twenty-four resistance trained men were randomly assigned to one of two groups: compression sleeve (GCS, n=11) or placebo sleeve (GPS, n=13). Participants performed 4 sets of 10 unilateral maximal eccentric/concentric elbow flexion repetitions on an isokinetic dynamometer at 120°s⁻¹ with 1 min of inter-set rest. Average torque, work and power were measured during concentric and eccentric actions. ANOVA revealed no significant interactions or main effects for group for any variable. However, values decreased significantly across sets for average torque (1st = 46.55 ± 11.11 Nm to 4th = 36.75 ± 8.78 Nm), average work (1st = 78.83 ± 18.49 J to 4th = 53.26 ± 10.04 J) and average power (1st = 52.3 ± 12.03 W to 4th = 32.59 ± 8.82 W). Therefore, the use of a graduated compression sleeve appears not enhance isokinetic elbow flexion muscle performance.

Full text

The Effects of Graduated Compression
Sleeves on Muscle Performance: A
Randomised Controlled Trial
Maria C. Pereira1, Martim Bottaro1, Lee E. Brown2,
Valdinar A. Rocha-Junior1, Saulo S. Martorelli1,
Murillo Neumann1, Jake Carmo1
1University of Brasília, Brasília, Brazil,
E-mail: mariaclaudiacarpe@yahoo.com.br
2California State University, Fullerton, California, USA.
ABSTRACT
The purpose of this study was to examine the effects of graduated
compression sleeves on muscle performance during high-intensity
exercise. Twenty-four resistance trained men were randomly assigned to
one of two groups: compression sleeve (GCS, n=11) or placebo sleeve
(GPS, n=13). Participants performed 4 sets of 10 unilateral maximal
eccentric/concentric elbow flexion repetitions on an isokinetic
dynamometer at 120°s-1 with 1 min of inter-set rest. Average torque, work
and power were measured during concentric and eccentric actions.
ANOVA revealed no significant interactions or main effects for group for any
variable. However, values decreased significantly across sets for average
torque (1st = 46.55 ± 11.11 Nm to 4th = 36.75 ± 8.78 Nm), average work (1st =
78.83 ± 18.49 J to 4th = 53.26 ± 10.04 J) and average power (1st = 52.3 ±
12.03 W to 4th = 32.59 ± 8.82 W). Therefore, the use of a graduated
compression sleeve appears not enhance isokinetic elbow flexion muscle
performance.
Key words: Compression Garments, Eccentric Muscle Action, Isokinetic
Exercise, Resistance Training
INTRODUCTION
Recently, compression garments have become popular among athletes as an ergogenic aid
that may enhance performance during competition and training. Current compression
garments range from whole body to isolated limb sleeves (e.g., tights, shorts, socks, sleeves
etc.). There is also a new graduated compression garment that provides varying degrees of
compression across a body segment. Typically, the graduate compression is greatest at the
distal end and decreases gradually to the proximal end of the isolated limb [1-2] .
Studies reported that compression garments may activate mechanoreceptors in superficial
tissue, enhance sensory feedback and improve proprioception [3-6]. These mechanisms
might enhance muscle performance. Several studies have demonstrated that lower-body
International Journal of Sports Science & Coaching Volume 9 · Number 5 · 2014 985
Reviewer: Andrew Fry (University of Kansas, USA)

compression garments provide physiological and performance benefits during multi-joint
exercises [2-5, 7-9]. Initial studies demonstrated that compression shorts increased vertical
jump performance by enhancing force and power production across repeated jumps [3-4]
possibly mediated by a reduction in muscle oscillation and enhancement of joint position
sense [4-5]. Most prior studies have primarily investigated the effects of compression
garments during lower-body continuous exercise [2, 5, 9-15], and several studies have
reported physiological and performance benefits [9, 13, 16-17]. Recently, upper-body
compression garments have become popular, albeit with little substantiating scientific
evidence.
Studies evaluated the effects of compression garments on upper-body recovery after
exercise [18-20] and their results indicated that the compression garments improved
recovery. However, to the best of our knowledge only two studies [17, 21] investigated the
effects of compression garments on upper-body performance during exercise. Dascombe et
al. [17] demonstrated no significant improvements in power output during continuous
simulated flat-water kayaking while wearing upper-body compression garments (full-length
long-sleeved tops). Moreover, Duffield and Portus [21] compared the effects of three types
of whole-body compression garments on performance and recovery in cricket players with
no benefits noted for repeat-sprint or throwing performance.
Although most previous studies have examined compression garments during lower-body
continuous exercise, there is a paucity of research related to the effects of upper-body
compression garments on intermittent high-intensity exercise. Furthermore, since
compression garments appear to improve muscle recovery, we hypothesized that upper-body
compression garment may enhance muscular performance during isokinetic intermittent
exercise. In addition, compression sleeves have become popular as an attempt to improve
performance during intermittent, high-intensity sports such as volleyball, baseball, softball,
basketball and track and field. Therefore, the purpose of this study was to examine the effects
of graduated compression sleeves on muscle performance during isokinetic intermittent
high-intensity exercise.
METHOD
EXPERIMENTAL APPROACH TO THE PROBLEM
A between-subjects randomised controlled trial design was used to examine the effects of
graduated compression sleeves on muscle performance via intermittent exercise. We used
this design because it is the most rigorous way of determining whether a cause-effect relation
exists between treatment and outcome [22]. Participants were randomly allocated to one of
two groups: graduated compression sleeve or placebo sleeve. They performed 4 sets of 10
maximal elbow flexions on an isokinetic dynamometer with their dominant arm. One minute
rest was given between sets and the sleeve was worn during the entire test.
SUBJECTS
Twenty-four resistance trained men (age: 24.1 ± 5.2 years; body mass: 78.6 ± 9.7 kg; height:
175.9 ± 6.2 cm) voluntarily participated. They had at least six months of experience
resistance training, a minimum of three times per week. All subjects completed a health
screening questionnaire prior to participation, were properly informed of all procedures,
purposes, benefits and risks, then signed a institutional ethics committee written informed
consent form. They were randomly assigned to one of two groups: graduated compression
sleeve (GCS, n= 11) or placebo sleeve (GPS, n= 13). Arm circumference was used to select
the size of the sleeve (Skins, Sydney, New South, Australia) in accordance with
986 The Effects of Graduated Compression Sleeves on Muscle Performance

manufacturer’s instructions (each product has a specific size chart and size calculator). The
placebo sleeve was visually similar to the graduated compression sleeve but without the
capacity for compression.
PROCEDURES
Participants completed an elbow flexion exercise protocol with their dominant arm. Exercise
was performed on an isokinetic dynamometer (Biodex System 3, Biodex Medical, Inc.,
Shirley, NY) at 120°s-1 which was calibrated prior to each testing session according to the
manufacturer’s specifications. Subjects were seated on a Scott Bench (preacher curl bench,
Gervasport, São Paulo, Brazil) with their elbow aligned with the axis of rotation of the
dynamometer (Figure 1). Range of motion was 0° to 130° of elbow flexion (0° at full
extension) [23]. Their forearm remained in a supinated position throughout the test. The
protocol consisted of 4 sets of 10 maximal eccentric/concentric actions. A one minute rest
interval was given between sets and verbal encouragement was given throughout the exercise
by the same investigator. Average torque, average work and average power during concentric
and eccentric actions were measured. The Biodex has previously been shown to be a reliable
(ICC= 0.86 to 0.98) and valid tool for the measurement of torque, work and power [24].
International Journal of Sports Science & Coaching Volume 9 · Number 5 · 2014 987
Figure 1. Scott Bench (preacher curl bench) adapted to the Isokinetic
Dynamometer

STATISTICAL ANALYSES
Data are reported as mean ± standard deviation. Separate 2 x 4 (group x set) mixed factor
ANOVAs were used to determine significant differences across sets for average torque,
average work and average power for both concentric and eccentric actions. Fisher least
significant difference (LSD) was used as a post hoc test for pairwise differences. Partial Eta
squared was calculated as a measure of effect size (ES) for each variable. Statistical
significance was set a priori at P < 0.05. All statistical procedures were performed using the
statistical software package SPSS 17 (SPSS Inc., Chicago, IL).
RESULTS
There were no significant group differences for age or anthropometric measures prior to
testing. There were also no significant interactions or main effects for group for any variable.
For concentric average torque, there was a significant F (1.60, 35.17) = 34.42, r = 0.61
main effect for time with values decreasing significantly across sets (1st > 2nd > 3rd > 4th)
(Figure 2 A). For eccentric average torque, there was a significant F (2.15, 47.29) = 227.60,
r = 0.91 main effect for time with values decreasing significantly across sets (1st > 2nd > 3rd
> 4th) (Figure 2 A).
For concentric average work, there was a significant F (1.66, 36.62) = 52.16, r = 0.70
main effect for time with values decreasing significantly across sets (1st > 2nd > 3rd & 4th)
(Figure 2 B). For eccentric average work, there was a significant F (1.98, 43.55) = 180.45, r
= 0.89 main effect for time with values decreasing significantly across sets (1st > 2nd > 3rd >
4th) (Figure 2 B).
For concentric average power, there was a significant F (1.32, 22.98) = 47.47, r = .79 main
effect for time with values decreasing significantly across sets (1st > 2nd > 3rd > 4th) (Figure
2 C). For eccentric average power, there was a significant F (1.58, 34.66) = 179.60, r = .89
main effect for time with values decreasing significantly across sets (1st > 2nd > 3rd > 4th)
(Figure 2 C).
DISCUSSION
The purpose of this study was to examine the effects of graduated compression sleeves on
muscle performance during intermittent high-intensity elbow flexion exercise. Our results
showed that average torque, work and power decreased significantly over the course of four
sets demonstrating a normal muscle fatiguing slope. However, the graduated compression
sleeves did not enhance isokinetic performance during concentric or eccentric actions.
A review by Born et al. [6] concluded that although there are beneficial effects of
compression garments on performance, they seem to be more pronounced when used for
recovery purposes, 12-48 hours after induced-muscle damage. Most prior studies of
compression garments on performance have only examined their effects on the lower-body,
making direct comparisons to our results difficult. Faulkner et al. [10] investigated the effects
of a variety of lower-limb compression garments on 400-m sprint performance and found no
significant differences when compared to a control condition. Many other studies have also
not found significant lower-body performance differences while wearing compression
garments [2, 7-8, 12, 17, 25-27]. In contrast, Kraemer et al. [3] demonstrated that
compression shorts resulted in maintenance of power in volleyball players during 10
consecutive maximal countermovement jumps but did not improve single maximal jump
power. Similarly, compression shorts significantly enhanced mean force and power before
and after different fatigue tasks, although without an increase in maximal power of the
highest jump [4]. Moreover, compression shorts reduced muscle oscillation upon impact and
988 The Effects of Graduated Compression Sleeves on Muscle Performance

International Journal of Sports Science & Coaching Volume 9 · Number 5 · 2014 989
Figure 2. Changes in average torque (A), average work (B) and average
power (C) of concentric and eccentric actions by group and set.
*significantly less than set 1. + significantly less than set 2. x significantly less
than set 3

improved position sense while enhancing proprioception. Improvements in position sense
and proprioception may have enhanced performance under conditions of fatigue [4]. Doan et
al. [5] evaluated compression shorts vs. loose-fitting gym shorts in university track athletes
and found that countermovement vertical jump height increased, and participants hip flexion
angle during a 60m sprint was reduced when they wore compression shorts. Additionally,
wearing compression shorts resulted in attenuated impact forces and a reduction in muscle
oscillation when landing from a jump [5].
We found only one study [17] that investigated the effects of upper-body compression
garments on upper-body performance. Dascombe et al. [17] examined the effects of wearing
upper-body compression garment on performance during simulated flat-water kayaking.
Five male and two female elite flat-water kayakers completed a six-step incremental test
followed by a four-minute maximal performance test. Participants performed two exercise
conditions: 1) full-length compression long-sleeved tops, and 2) no shirt or sports training
bra. Performance measures such as power, distance covered, and stroke rate were recorded
during the tests. No significant differences between the upper-body compression garment
and control conditions were evident for any performance variable. They reported that the null
effect may be due to low compression provided by the compression garment at the agonist
muscles used for kayaking, which are located on the torso of the body (i.e., rotator cuff,
serratus anterior, rhomboid major and latissimus dorsi). Although Dascomb et al. [17] have
investigated the effects of upper-body compression garments on performance during
continuous exercise, our data are in agreement with their results.
Furthermore, Duffield and Portus [21] submitted 10 male cricket players to four
randomised exercise sessions (three types of full-body compression garments and a control).
Each session consisted of a 20 m sprint every minute, separated by 45 s of submaximal
exercise. All compression garments were worn during the entire testing session and 24 h after
exercise. Participants performed a maximal distance throwing test of five maximal cricket
ball throws, before and after the exercise session. Performance on the accuracy throwing was
measured by throws at a custom designed target at 10, 20 and 30 min of the exercise session.
They found no significant differences in repeat-sprint performance, throwing distance or
accuracy between conditions. Although other researchers have investigated the effects of a
lower-body exercise protocol on sports-specific upper-body performance, our results are in
agreement with their findings. Furthermore, it has been suggested that compression garments
may interact with receptors present in skin, muscle, ligaments and joint capsules barrack [28-
29] that enhance sensory feedback, resulting in improved proprioception. Therefore, the lack
of performance enhancement in the present study may be related to exercise mode. During
the isokinetic high-intensity elbow flexion exercise in the present study, the limb is stable and
subjected to low impact forces. In addition, the dynamometer maintains the movement
pattern throughout the range of motion and may reduce proprioceptive mechanism
requirements [30].
CONCLUSION
We found no muscle performance improvements with compression sleeves during
intermittent high-intensity isokinetic elbow flexion exercise. Average torque, work and
power decreased significantly over the course of four sets and showed a normal fatiguing
pattern, but eccentric and concentric values were not significantly different across sets
between placebo and compression sleeves. Although graduated compression sleeves did not
enhance muscle performance during intermittent high-intensity isokinetic exercise they also
did not hinder it. Therefore, coaches and athletes may use graduated compression sleeves at
990 The Effects of Graduated Compression Sleeves on Muscle Performance

their preference for other purposes, such as improving recovery or prevention of muscle
damage. Future studies should attempt to verify the effects of graduated compression sleeves
on performance during other types of exercise and in different populations.
ACKNOWLEDGMENT
This study was partially supported by the Brazilian Council for the Research Development
(CNPq).
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