Determination of Interface Pressure Profiles

Using Indirect Approach

Barhoumi Houda1(B) , Marzougui Saber2 , and Ben Abdessalem Saber1

1 Textile Materials and Processes Research Unit, University of Monastir, Monastir, Tunisia
houda.barhoumi@enim.u-monastir.tn
2 Laboratory of Textile Engineering, University of Monastir, Monastir, Tunisia

Abstract. The compression garments are characterized by the interface pressure

they apply to a human body area. In this investigation, an indirect approach for
measuring the interface pressure from a set of compression bands was developed.
The Young modulus and the desired deformation values were determined. The
calculated pressure values were compared against FlexiForce® sensor readings
measured on 10 volunteers. After verifying the validity of this method, the interface
pressure profiles along the leg were plotted.

Keywords: Interface pressure · Indirect method · Mechanical properties ·

Compression garment

1 Introduction
The concept of compression therapy stockings is based on a simple mechanical principle:
By compressing the limb with graduated compression, strong at the ankle and decreasing
as it goes up the leg, the compression stocking helps venous return, decreases venous
pressure, prevents venous stasis and efficiently relieves aching and heavy legs (Partsch
et al. 2008). Recently, there are a number of devices that measure the interface pressure
from a compression fabric. These include using a direct testing approach where a sensor
is placed on a patient’s leg or a wooden cylinder model to observe pressure readings
(Flaud et al. 2010). There are a few devices that allow a constant reliable observation
with minimal costs, and while, these devices have proved useful in industry use, they
are known to have weaknesses, such as limits in shape sizes.
This study presents an indirect testing approach that requires the use of a tensile tester
commonly used in textile testing laboratories to evaluate the efficiency of compression
therapy products.

2 Materials and Methods

Our indirect testing method was based on the use of a Lloyd S5 Testing Machine. In
order to mimic the shape of the wanted leg area, customized grips (Fig. 1) were designed
and fitted to the Lloyd S5 machine. Four jersey knitted compression bands (G1, G2, G3
and G4) were tested in this investigation. Their characteristics are presented in Table 1.

© The Author(s), under exclusive license to Springer Nature Switzerland AG 2022

S. Msahli and F. Debbabi (Eds.): CIRATM 2020, SPM 17, pp. 193–197, 2022.
https://doi.org/10.1007/978-3-031-08842-1_31
194 B. Houda et al.

Fig. 1. Customized grips for Lloyd S5 testing machine.

Table 1. Characteristics of tested samples

Characteristics Unit Sample code

G1 G2 G3 G4
Yong modulus MPa 0.696 0.786 0.633 0.411
Polyamide 6-6 count dTex 77 77 77 77
Elastane percentage % 10 15 15 8
Fabric weight g/m2 222 227 232 199
Fabric thickness mm 0.742 0.95 0.87 0.8
Fabric circumference cm 20.6 20.6 20.6 20.6

The tension – deformation curves of the four knitted bands are presented in the Fig. 2.
A new model (Eq. 1) based on Laplace’s law has been developed in our previous
work (Barhoumi et al. 2020). This model was used to calculate the theoretical interface
pressure values (mmHg).
P = 2πεEe
(1)
C
where P is the interface pressure in mmHg, E is the Young modulus in MPa, e is the
sample’s thickness in mm, C is the circumference of the body leg in mm and ε is the
knitted band deformation at the wanted circumference.
In order to evaluate the effectiveness of the proposed indirect approach, it was nec-
essary to compare the calculated data to direct pressure readings from a human limb. For
this reason, ten healthy female subjects agreed to take part in this study. Their size and
their average age are respectively 40 and 27 years old. A force-pressure sensor, “Flexi-
Force A201” sensor, was used to measure the experimental interface pressure (Barhoumi
et al. 2018).
 Determination of Interface Pressure Profiles 195

Fig. 2. Tension-Deformation curves of the different samples.

3 Results and Discussions

3.1 Assessment of the Indirect Approach
The standard deviation (SD) was used to quantify the amount of dispersion of experi-
mental or direct interface pressure values. As shown in Table 2, for all the tested samples,
the SD values are inferior to 1. This means that the distribution of the values around the
mean direct interface pressure value is acceptable.
To validate the indirect approach, the error percentage between direct and indirect
interface pressure values was calculated. We notice that it never exceeds 5% for all
the tested samples Thus, there is no discrepancy between direct and indirect interface
pressure values as the percentage error value can be evaluated as tolerable.

Table 2. Comparison between direct and indirect interface pressure values

C = 27.5 cm Indirect pressure (mmHg) Direct pressure (mmHg) Error (%)

Average value (mmHg) SD
G1 22.03 21.25 0.45 3.67
G2 22.9 22.1 0.31 3.62
G3 21.23 21.54 0.74 1.44
G4 17.95 18.8 0.62 4.52

3.2 Interface Pressure Profiles

The tight-fitting garment, such as the tested elastic bands, apply an amount of pressure to
a specific area of the body through its own elasticity and stretch recovery performance.
Hence, it is important to know the distribution profile of the interface pressure applied
along the leg.
196 B. Houda et al.

After validating the indirect approach, the interface pressure values are calculated
and the average pressure profiles at four positions along the leg were plotted as shown
in Fig. 3.

Fig. 3. Interface pressure profiles of the different samples using the indirect method

It is noticeable from the interface pressure profiles that the compression bands gen-
erate a variable pressure gradient along the lower limb. The body shape has a significant
effect on the interface pressure distribution. Indeed, the human leg has an irregular geom-
etry. Therefore, the tension applied and the pressure generated by the compression bands
cannot be uniformly distributed. According to Eq. (1), the greater interface pressure on
the lower limb will occur in the region with the lower circumference. As shown on Fig. 3,
the performance of pressure levels in the ankle (circumference = 27.5 cm) is higher than
those at the other positions.
For compression stockings to be effective, desirable pressure is of great importance.
Inadequate interface pressure will be ineffective in venous disease reduction, and exces-
sive pressure may compress arterioles without improving the venous flow (Partsch 2005).
In literature, some study indicated that many compression stockings did not apply a suf-
ficient amount of pressure on the wanted area, as claimed by the manufacturers (Best
et al. 2000; Veraart et al. 1997). Therefore, implementing this testing approach could
assist manufacturers of compression hosieries in gathering significant data as tensile
testing machines are widely available across many physical testing laboratories.

4 Conclusion
In this study, we presented an indirect approach using custom grips that simulate the
circumference of the body part. Based on the modified Laplace’s law, the theoretical
interface pressure values were calculated and compared with the experimental ones.
 Determination of Interface Pressure Profiles 197

It was found that the proposed indirect approach presents a good agreement with the
experimental results. This funding is of great interest to the manufacturers of compression
garment because it is simple, not expensive, valid and adequate.

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