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Add exercise to compression for faster healing of venous leg ulcers

Add exercise to compression for faster healing of venous leg ulcers

According to a new study, Patients with venous leg ulcers who add exercise to compression therapy are more likely to experience healing than those who use compression therapy alone. The meta-analysis has appeared in JAMA Dermatology.

Exercise is recommended as an adjuvant treatment for venous leg ulceration (VLU) to improve calf muscle pump function.

Dr Andrew Jull and colleagues conducted a systematic review and Meta-analysis to evaluate whether exercise regimen adjuvant to compression was associated with increased venous leg ulcer healing compared with compression alone. The study was to find out the association of different exercise interventions with VLU healing when used as an adjuvant to any form of compression.

Researchers examined data from five trials in which 190 adults with venous leg ulcers were randomized to an exercise program or no exercise; all were receiving compression therapy as standard care. Overall, 61% of patients who exercised had ulcer healing at 12 weeks, versus 46% of those who didn’t exercise. Exercise regimens that included progressive resistance exercises (e.g., heel raises) plus activities like walking appeared most effective.

The investigators report using the following exercise interventions were included: exercise alone (two RCTs, 53 participants), progressive resistance exercise and prescribed physical activity (two RCTs, 102 participants), walking (one RCT, 35 participants), and ankle exercise (one RCT, 40 participants).

Two trials had participants with adverse events. In one of the trials, the researchers reported, if only the first event of a type was considered, 38 events were reported by intervention participants and 26 by usual care participants (OR 1.32; 95% CI 0.95-1.85), while the second trial reported two non-serious adverse events related to exercise and no adverse events among the group of patients receiving standard care.

The researchers concluded that the 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.

Daily sets of heel raises plus physical activity (eg, walking at least 3 times per week) may be an effective adjuvant to compression for treating venous leg ulceration. The experts feel that they were now empowered to recommend exercise for patients with [venous leg ulcers], while we await further studies that better elucidate how to best target this intervention.

For further reference log on to : doi:10.1001/jamadermatol.2018.3281

Source: With inputs from JAMA Dermatology

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