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Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial.
Br J Dermatol. 2018 05; 178(5):1072-1082.BJ

Abstract

BACKGROUND

Venous leg ulcers (VLUs) are typically painful and heal slowly. Compression therapy offers high healing rates; however, improvements are not usually sustained. Exercise is a low-cost, low-risk and effective strategy for improving physical and mental health. Little is known about the feasibility and efficacy of supervised exercise training used in combination with compression therapy patients with VLUs.

OBJECTIVES

To assess the feasibility of a 12-week supervised exercise programme as an adjunct therapy to compression in patients with VLUs.

METHODS

This was a two-centre, two-arm, parallel-group, randomized feasibility trial. Thirty-nine patients with venous ulcers were recruited and randomized 1 : 1 either to exercise (three sessions weekly) plus compression therapy or compression only. Progress/success criteria included exercise attendance rate, loss to follow-up and patient preference. Baseline assessments were repeated at 12 weeks, 6 months and 1 year, with healing rate and time, ulcer recurrence and infection incidents documented. Intervention and healthcare utilization costs were calculated. Qualitative data were collected to assess participants' experiences.

RESULTS

Seventy-two per cent of the exercise group participants attended all scheduled exercise sessions. No serious adverse events and only two exercise-related adverse events (both increased ulcer discharge) were reported. Loss to follow-up was 5%. At 12 months, median ulcer healing time was lower in the exercise group (13 vs. 34·7 weeks). Mean National Health Service costs were £813·27 for the exercise and £2298·57 for the control group.

CONCLUSIONS

The feasibility and acceptability of both the supervised exercise programme in conjunction with compression therapy and the study procedures is supported.

Authors+Show Affiliations

Centre for Sport and Exercise Science.Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, NE1 8ST, U.K.Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, S10 2BP, U.K.Centre for Sport and Exercise Science.Manor Clinic, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S12 2ST, U.K.School of Sport and Exercise Science, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, U.K.School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, U.K.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Video-Audio Media

Language

eng

PubMed ID

29077990

Citation

Klonizakis, M, et al. "Supervised Exercise Training as an Adjunct Therapy for Venous Leg Ulcers: a Randomized Controlled Feasibility Trial." The British Journal of Dermatology, vol. 178, no. 5, 2018, pp. 1072-1082.
Klonizakis M, Tew GA, Gumber A, et al. Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial. Br J Dermatol. 2018;178(5):1072-1082.
Klonizakis, M., Tew, G. A., Gumber, A., Crank, H., King, B., Middleton, G., & Michaels, J. A. (2018). Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial. The British Journal of Dermatology, 178(5), 1072-1082. https://doi.org/10.1111/bjd.16089
Klonizakis M, et al. Supervised Exercise Training as an Adjunct Therapy for Venous Leg Ulcers: a Randomized Controlled Feasibility Trial. Br J Dermatol. 2018;178(5):1072-1082. PubMed PMID: 29077990.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Supervised exercise training as an adjunct therapy for venous leg ulcers: a randomized controlled feasibility trial. AU - Klonizakis,M, AU - Tew,G A, AU - Gumber,A, AU - Crank,H, AU - King,B, AU - Middleton,G, AU - Michaels,J A, Y1 - 2018/03/06/ PY - 2017/10/19/accepted PY - 2017/10/28/pubmed PY - 2019/9/24/medline PY - 2017/10/28/entrez SP - 1072 EP - 1082 JF - The British journal of dermatology JO - Br J Dermatol VL - 178 IS - 5 N2 - BACKGROUND: Venous leg ulcers (VLUs) are typically painful and heal slowly. Compression therapy offers high healing rates; however, improvements are not usually sustained. Exercise is a low-cost, low-risk and effective strategy for improving physical and mental health. Little is known about the feasibility and efficacy of supervised exercise training used in combination with compression therapy patients with VLUs. OBJECTIVES: To assess the feasibility of a 12-week supervised exercise programme as an adjunct therapy to compression in patients with VLUs. METHODS: This was a two-centre, two-arm, parallel-group, randomized feasibility trial. Thirty-nine patients with venous ulcers were recruited and randomized 1 : 1 either to exercise (three sessions weekly) plus compression therapy or compression only. Progress/success criteria included exercise attendance rate, loss to follow-up and patient preference. Baseline assessments were repeated at 12 weeks, 6 months and 1 year, with healing rate and time, ulcer recurrence and infection incidents documented. Intervention and healthcare utilization costs were calculated. Qualitative data were collected to assess participants' experiences. RESULTS: Seventy-two per cent of the exercise group participants attended all scheduled exercise sessions. No serious adverse events and only two exercise-related adverse events (both increased ulcer discharge) were reported. Loss to follow-up was 5%. At 12 months, median ulcer healing time was lower in the exercise group (13 vs. 34·7 weeks). Mean National Health Service costs were £813·27 for the exercise and £2298·57 for the control group. CONCLUSIONS: The feasibility and acceptability of both the supervised exercise programme in conjunction with compression therapy and the study procedures is supported. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/29077990/full_citation L2 - https://doi.org/10.1111/bjd.16089 DB - PRIME DP - Unbound Medicine ER -