Compression versus inner sole for venous patients with foot static disorders: a prospective trial comparing symptoms and quality of life. (February 2015) - Uhl, Jean-François
Objective: To prospectively compare the improvement in quality of life and symptoms achieved when using two treatments—medical compression stockings and inner sole—in subjects with symptomatic chronic venous disease in the presence of foot static disorders. Materials and methods: This prospective study included 24 patients with a symptomatic chronic venous disease associated with foot static disorders. The basic CEAP was used to classify the patients. The venous symptoms were recorded using a 10-point visual analog scale and scored using a customized questionnaire. Patient-reported quality of life data were acquired using a CIVIC questionnaire. A standardized measurement of the Djian-Annonier angle was used to quantify the foot static disorders. We compared the use of the following two treatments: medical compression stockings (18 mm of Hg) and inner sole. For this comparison, we used a crossover technique over 4 successive weeks. Results: One male and 23 female patients were included in this study. We found significant improvement in quality of life scores when only medical compression stockings were used ( p < 0.005), only inner sole were used ( p < 0.01) and also when both treatments were used together ( p < 0.001), compared with no treatment. This was mainly observed for the somatic component of CIVIC. The symptoms of pain, heaviness, swollen feeling, and cramps were significantly improved by the two treatments, whether given separately ( p < 0.001) or together ( p < 0.0001). No additive effect of the treatments was observed. Conclusion: This study suggests that a number of leg symptoms occurring in varicose veins patients are not likely to have a venous origin. They are frequently related to a foot static disorder, which is responsible for postural changes. This study also strongly demonstrates the need for correction of the foot static disorder if such a disorder is present in any patient with chronic venous disease. The use of the inner sole will improve the symptoms and also the quality of life with an efficiency that is almost equal to that provided by the medical compression stockings and the combined use of both treatments is recommended.