The influence of exercise on ulcer healing in patients with chronic venous insufficiency

Mutlak, Omar; Aslam, Mohammed; Standfield, Nigel

doi:10.23736/s0392-9590.18.03950-0

Cited by 39 publications

(51 citation statements)

References 194 publications

(229 reference statements)

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“…More than half ( n = 11) of PA/exercise programmes were conducted in the home environment without supervision 37,38,41,42,44–49,52 . Three studies utilised a small group format ( n = 4 participants per group) that also involved direct supervision by a qualified exercise physiologist 43,47,51 .…”

Section: Resultsmentioning

confidence: 99%

“…For outcomes used to measure VLU healing status, three studies reported time to heal, 18,42,51 six studies reported proportion of ulcer healing, 37,38,42,44,48,51 and nine studies reported rate of changes in the area of ulcer 37–40,42,45,49–51 during the trial period (see Supporting Information S6). One study reported ulcer recurrence rates 51 .…”

Section: Resultsmentioning

confidence: 99%

“…Participants were asked to take 10,000 steps per day More than half (n = 11) of PA/exercise programmes were conducted in the home environment without supervision. 37,38,41,42,[44][45][46][47][48][49]52 Three studies utilised a small group format (n = 4 participants per group) that also involved direct supervision by a qualified exercise physiologist. 43,47,51 A summary of PA interventions is presented in Table 3, with additional details (in accordance with CERT recommendations) provided in Supporting Information S5.…”

Section: Participantsmentioning

confidence: 99%

“…Details of baseline participants characteristics are summarised in Supporting Information S4. resistance exercise, ankle/foot range of motion exercise), 37,38,42,43,[45][46][47][48][49][50] and five studies reported PA/exercise interventions involving multicomponent exercise interventions (i.e., resistance exercise plus aerobic exercise/walking and/or ankle/foot range of motion exercise). [39][40][41]44,51 A summary of exercise components involved in PA/exercise interventions in eligible studies is outlined in Table 2.…”

Section: Participantsmentioning

confidence: 99%

“…48 To facilitate and encourage participants to perform exercise independently at home, three studies reported the utilisation of visual tools (e.g., exercise booklets) and motivational strategies (e.g., phone calls, text messages) during trial period. For outcomes used to measure VLU healing status, three studies reported time to heal, 18,42,51 six studies reported proportion of ulcer healing, 37,38,42,44,48,51 and nine studies reported rate of changes in the area of ulcer [37][38][39][40]42,45,[49][50][51] during the trial period (see Supporting Information S6). One study reported ulcer recurrence rates.…”

Section: Participantsmentioning

confidence: 99%

See 4 more Smart Citations

Effects of physical activity as an adjunct treatment on healing outcomes and recurrence of venous leg ulcers: A scoping review

Qiu

Osadnik

Team

et al. 2022

Wound Repair Regeneration

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Healing time is protracted and ulcer recurrence is common in patients with venous leg ulcers. Although compression is the mainstay treatment, many patients do not heal timely. Physical activity may be a clinically effective adjunct treatment to compression to improve healing outcomes. This scoping review provides a broad overview of the effect of physical activity as an adjunct treatment to compression on wound healing and recurrence. We followed the six‐step framework developed by Arksey and O'Malley. We searched electronic databases and trial registration websites for relevant studies and ongoing trials. Two authors independently screened and selected articles. Findings were presented in a descriptive statistical narrative summary. We consulted and presented our findings to the wound consumer group to ensure the relevance of our study. Physical activity interventions in 12 out of the 16 eligible studies consisted of only one component, eight studies were resistance exercises, three studies reported ankle and/or foot range of motion exercises, and one study reported aerobic/walking exercises. The remaining four studies involved multicomponent exercise interventions. Resistance exercise combined with ankle and/or foot range of motion exercise minimised ulcer size on day 12 (intervention group: 4.55 ± 1.14 cm2 vs. control group: 7.43 ± 0.56 cm2) and improved calf muscle pump performance on day 8 (ejection fraction: 40%–65%; residual volume fraction: 56%–40%). We identified one study that reported ulcer recurrence rate with no clinical difference in the intervention group versus the control group (i.e., 12% in intervention vs. 5% in control). Our review identified that resistance exercise was the most common type of physical activity intervention trialled in the published literature. Resistance exercise combined with ankle and/or foot range of motion exercise appears to be effective adjunct treatments; however, the overall evidence is still relatively weak as most programmes had a short intervention period which limited clinical outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

See 3 more Smart Citations

Effects of physical activity as an adjunct treatment on healing outcomes and recurrence of venous leg ulcers: A scoping review

Qiu

Osadnik

Team

et al. 2022

Wound Repair Regeneration

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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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Varicose Veins After Pregnancy: Prevention and Treatment

Rangel

2023

Post-Maternity Body Changes

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The influence of exercise on ulcer healing in patients with chronic venous insufficiency

Abstract: A thesis submitted to Imperial College London for the degree of MD(Res)

Cited by 39 publications

References 194 publications

Effects of physical activity as an adjunct treatment on healing outcomes and recurrence of venous leg ulcers: A scoping review

Effects of physical activity as an adjunct treatment on healing outcomes and recurrence of venous leg ulcers: A scoping review

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

Varicose Veins After Pregnancy: Prevention and Treatment

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