Characterizing the biomechanical transmission effects of elastic compression stockings on lower limb tissues by using 3D finite element modelling

[Display omitted] •A new FE model to simulate the interface pressure between elastic compression stockings and the lower limb with validation was constructed.•A new analytical method to determine cross-sectional body curvatures and interface pressure variations caused by elastic compression materials was proposed.•The simulated results contribute to explore stress distributions and tissue deformation exerted by elastic compression stockings.•The characterized mechanical transmission mechanisms facilitate functional design and evaluation of compression materials/textiles/apparel for applications. Studies have primarily simulated the interface pressure and skin surface stress produced by compression textiles or garments with a single pressure level. However, only a few studies have reported the biomechanical transmission behaviors of compression fabrics from the skin to deeper soft tissues of the human body, especially within the context of compression fabrics providing multiple pressure levels. Therefore, to address this limitation, this study developed novel 3D finite element (FE) models to characterize and visualize the interface pressure exerted at the skin surface by elastic compression stockings (ECSs), a type of typical compression textiles, with either low- or high-pressure levels, and to analyze the resulting stress and stress transmission effects within lower limb tissues. The results of the validated FE models indicated that the simulated interface pressure favorably agreed with the measured pressure data. A close relationship existed between the pressure magnitudes and the lower limb surface curvatures, with the highest interface pressure occurring at the anterior and posterior bony regions of the ankle with greater surface curvatures than those of the posterior calf. The internal tissue stress distributions largely varied, which may be one of the potential causes for the inconsistency observed between the claimed pressure doses and those practically delivered inside. Overall, this study serves to improve the understanding of the working mechanisms of the ECS-lower limb system, allowing for improved functional material design and evaluation of the pressure effectiveness of compression textiles and garments used in physiotherapy.