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[3 min read] Venous leg ulcers: exercise with compression vs compression alone
Is an exercise regimen combined with compression more effective at treating venous leg ulcers than just compression alone? Exercise is recommended as an adjuvant treatment for venous leg ulceration to improve calf muscle pump function. However, the association of exercise with leg ulcer healing has not been properly aggregated, and the effectiveness of different exercise interventions has not been characterised.
Researchers conducted a systematic review and meta-analysis including five randomised clinical trials comprising 190 patients with venous leg ulceration. The exercise interventions were progressive resistance exercise alone (53 participants) or combined with prescribed physical activity (102 participants), walking only (35 participants), or ankle exercises (40 participants).
Overall, exercise was associated with increased leg ulcer 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).
The study concluded that daily sets of heel raises plus physical activity (such as walking at least three times per week) may be an effective adjuvant to compression for treating venous leg ulceration.
The evidence base may now be sufficiently suggestive for clinicians to consider recommending simple progressive resistance and aerobic activity to suitable patients with venous leg ulcers while further research is produced.
Source: Jull A, Slark J, Parsons J. Prescribed Exercise With Compression vs Compression Alone in Treating Patients With Venous Leg Ulcers: A Systematic Review and Meta-analysis. JAMA Dermatol. 2018;154(11):1304–1311. doi:10.1001/jamadermatol.2018.3281
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