An investigation of skin perfusion in venous leg ulcer after exercise

Mutlak, Omar; Aslam, Mohammed; Standfield, Nigel

doi:10.1177/0267659117723699

Cited by 4 publications

(6 citation statements)

References 12 publications

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“…Eight hundred fifty-three titles were obtained from searches (Figure 1). Five studies met the inclusion criteria, and 1 study was potentially relevant but did not publish healing outcomes . We contacted the corresponding author who confirmed healing outcomes had been collected, and provided us with a prepublication copy of a second article.…”

Section: Resultsmentioning

confidence: 99%

Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers

2018

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IMPORTANCEExercise is recommended as an adjuvant treatment for venous leg ulceration (VLU) to improve calf muscle pump function. However, the association of exercise with VLU healing has not been properly aggregated, and the effectiveness of different exercise interventions has not been characterized. OBJECTIVETo summarize the association of different exercise interventions with VLU healing when used as an adjuvant to any form of compression.DATA SOURCES The Cochrane Controlled Trials Register, MEDLINE, Embase, CINAHL, PsycInfo, and SCOPUS databases were searched through October 9, 2017.STUDY SELECTION Randomized clinical trials (RCTs) of any exercise compared with no exercise in participants with VLU were included, where compression was used as standard therapy and a healing outcome was reported. Independent title screening and full text review by 2 authors (A.J., J.S.) with appeal to a third author (J.P.) if disagreement was unresolved. Of the 519 articles screened, a total of 6 (1.2%) studies met the inclusion criteria for systematic review, including 5 for meta-analysis.DATA EXTRACTION AND SYNTHESIS Independent quality assessment for Cochrane risk of bias and data extraction by 2 authors with appeal to third author if disagreement unresolved (PRISMA). Data pooled using fixed effects model. MAIN OUTCOMES AND MEASURESThe a priori primary outcome was any healing outcome (proportion healed, time to healing, or change in ulcer area). Secondary outcomes (adverse events, costs, and health-related quality of life) were only collected if a primary outcome was reported.RESULTS Six RCTs were identified and 5 (190 participants) met inclusion criteria for meta-analysis. The exercise interventions were progressive resistance exercise alone (2 RCTs, 53 participants) or combined with prescribed physical activity (2 RCTs, 102 participants), walking only (1 RCT, 35 participants), or ankle exercises (1 RCT, 40 participants). Overall, exercise was associated with increased VLU healing at 12 weeks although the effect was imprecise (additional 14 cases healed per 100 patients; 95% CI, 1-27 cases per 100; P = .04). The combination of progressive resistance exercise plus prescribed physical activity appeared to be most effective, again with imprecision (additional 27 cases healed per 100 patients; 95% CI, 9-45 cases per 100; P = .004). CONCLUSIONS AND RELEVANCEThe evidence base may now be sufficiently suggestive for clinicians to consider recommending simple progressive resistance and aerobic activity to suitable patients with VLU while further research is produced.

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Section: Resultsmentioning

confidence: 99%

Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers

2018

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“…Las intervenciones tuvieron una duración entre siete días a tres meses. Hubo diversidad en el número de sesiones y la forma de entregarlas y ejecutarlas, desde tres sesiones por Skype de 10-15 minutos, con visitas previas en el hogar de 90 minutos (36) (42)(43)(44)(45)47). Y los lugares de entrega fueron clínicas de atención ambulatoria (22,32,(37)(38)(39)(44)(45)(46)(47), hogares de los pacientes y centros deportivos universitarios (41).…”

Section: Componentes Modo Proveedor Y Lugar De Entregaunclassified

“…El hecho de que las intervenciones de ejercicio (20,(35)(36)(37)(38)(39)(40)(41)(42)(43) hayan sido las más frecuentes en la literatura podría explicarse por la evidencia existente sobre la fisiopatología de las UV, aunque no es exacta, se cree que la falla de la bomba muscular de la pantorrilla, que resulta en una elevación sostenida de la presión venosa ambulatoria contribuye a su formación, en comparación con sujetos sanos, los pacientes con IVC tienen una fracción de eyección reducida y un índice de llenado venoso aumentado, lo que indica un deterioro en la capacidad de eyección de la bomba muscular de la pantorrilla así como poca competencia venosa (55)(56). De manera que, los programas de ejercicio que consisten en estiramiento y fortalecimiento de los músculos de las extremidades inferiores junto con ejercicios aeróbicos como caminar, contribuyen a mejorar el retorno venoso, aumentan la movilidad de la articulación del tobillo con el consiguiente fortalecimiento de los músculos de la pantorrilla y la actividad hemodinámica de esta bomba muscular (57)(58)(59).…”

Section: De Franciscis (45) Et Al Italia 2013unclassified

Intervenciones de estilo de vida en pacientes con úlceras venosas y su asociación con la cicatrización: scoping review

Cifuentes-Rodríguez

Guerrero-Gamboa

2021

Hacia Promoc. Salud

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Objetivos: identificar y describir la evidencia disponible sobre intervenciones de estilo de vida diseñadas para promover la cicatrización y prevenir la recurrencia de úlceras venosas. Métodos: scoping review guiada por el marco metodológico de Arksey y O’Malley, de estudios de intervención publicados entre los años 2008-2020 en idioma inglés, español y portugués en las bases de datos PubMed, Cochrane Library y CINAHL, utilizando las palabras clave: venous leg ulcer, lifestyle intervention, nutritional support, exercise, wound healing, recurrence. Resultados: veinte estudios fueron incluidos en la síntesis. La mayoría de las intervenciones se enfocaron en promover el ejercicio y analizar sus efectos en la cicatrización de las úlceras venosas. Solo cuatro estudios de intervención abordaron el aspecto nutricional de estos pacientes y apenas tres determinaron la recurrencia. Los hallazgos son limitados debido a la diversidad en la concepción y ejecución de las intervenciones disponibles además de las muestras pequeñas en los estudios. Conclusiones: la evidencia existente sugiere que las intervenciones que promueven la actividad física y el ejercicio podrían tener un efecto beneficioso en la cicatrización y prevención de recurrencia de úlceras venosas, sin embargo, falta una base sólida de evidencia en intervenciones de estilo de vida para estos pacientes. La investigación actual proporciona algunas ideas sobre los componentes específicos que deben considerarse al planificar tales intervenciones en el futuro.

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“…They have shown that a 12‐week supervised exercise program improved measures of cutaneous microvascular reactivity in people being treated with compression therapy for venous ulceration. Mutlak and co‐workers (2018) have shown that VLU healing as the size of the ulcer was seen to have decreased significantly in the patients who had performed regular exercise 37 . It appears that the combination of progressive resistance exercises and aerobic activity (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…The exercise was shown to have a significant effect on VLU healing, particularly when combined with compression therapy. 27 , 37 Patients receiving both compression therapy and progressive tailored exercise training have a higher quality of life. 38 Tew and co‐workers (2018) described that cutaneous microvascular reactivity may facilitate the healing of VLU.…”

Section: Introductionmentioning

confidence: 99%

Chronic venous insufficiency and venous leg ulcers: Aetiology, on the pathophysiology‐based treatment

Krizanova,

Penesova,

Hokynkova

et al. 2023

International Wound Journal

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The chronic venous disease covers a wide spectrum of venous disorders that are characterized by severely impaired blood return that primarily affects veins in the lower extremities. Morphological and functional abnormalities of the venous system led to chronic venous insufficiency (CVI), and present as leg heaviness/achiness, edema, telangiectasia, and varices. The term ‘chronic venous insufficiency’ (CVI) refers to a disease of greater severity. Venous dysfunction is associated with venous hypertension and is associated with venous reflux due to poorly functioning or incompetent venous valves, which ultimately reduces venous return, leading to a cascade of morphological, physiological, and histologic abnormalities such as blood pooling, hypoxia, inflammation, swelling, skin changes (lipodermatosclerosis), and in severe cases, venous leg ulcers (VLU). This review summarizes recent knowledge about the aetiology, risk factors, and pathophysiology of VLU and compared the possibilities of their treatment.

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An investigation of skin perfusion in venous leg ulcer after exercise

Abstract: Perfusion measurements showed significant changes after three months of regular exercise. We conclude that exercise has a significant effect on tissue perfusion parameters in venous leg ulcer and this effect may play a role in understanding the pathophysiology of VLU.

Cited by 4 publications

References 12 publications

Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers

Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers

Intervenciones de estilo de vida en pacientes con úlceras venosas y su asociación con la cicatrización: scoping review

Chronic venous insufficiency and venous leg ulcers: Aetiology, on the pathophysiology‐based treatment

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