Graduated compression stocking performance: Insights from wearers and development of a cost-effective 3D-printed leg mannequin

Compression textiles are prevalent in sports, healthcare and medical products. However, challenges have appeared in designing graduated compression stockings, including the need for systematic studies on leg geometry and the complex pressure-measuring process. This study investigated the pressure performance of suggested and undersized stockings, particularly when the wearer's leg size exceeds the supplier's recommendations. The relationship between pressure and the wearer’s body fat, muscle mass, bone percentage and body mass index (BMI) was also analyzed. A 3D-printed leg mannequin was developed to predict the pressure exerted on human legs. Fifteen healthy female adults were recruited to evaluate two commercially available travel-oriented graduated compression stockings in a seated position with 90° knee flexion. This study found that both stockings failed to provide the theoretical pressure gradient in which the highest pressure was found at below calf (b 1 ). The stocking wearer should ensure that both their legs and the selected stocking sizes align with the supplier’s recommendations to avoid unexpectedly high pressure applied to their legs. Among body fat, muscle mass, bone percentage and BMI, only pressure measured at below calf (b 1 ) can be predicted by bone percentage. Furthermore, the developed 3D-printed leg mannequin can be cost-effective for pressure evaluation in the initial compression stocking development stages. It helps reduce the need for repeated human trials while enabling customization to replicate different leg shapes and sizes, thereby conserving time and resources in the research process. Future studies should be conducted with an improved design of the leg mannequin and more extensive participant groups.