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

BACKGROUND: Venous leg ulcer (VLU) affects millions of people, and yet there have been no major advances in its treatment for many decades. Is it the time to change our approach, and try a multidisciplinary one that could bring about a change? The aim of this study is to evaluate whether a regular, home-based exercise could be influential in healing the VLU.

METHODS: Eighty subjects (mean age: 65.13 years) were recruited for 12 weeks. The participants were randomized into a control group (N.=20), a compression therapy group (N.=20), an exercise group (N.=20) and a compression and exercise group (N.=20). The exercise comprised of 10 dorsiflexions each hour while the patient was awake. The first 2 groups did not perform any exercise while the other two did. Baseline and 3-month measurements were performed. These measurements include skin perfusion assessment and ulcer size.

RESULTS: All patients showed low tcPO2 in the beginning of the study. At the point of 3 months of exercise, Laser Doppler flowmetry and ulcer size measurements showed significant decrease, P<0.001 in exercise groups, however, no real change was demonstrated in the non-exercise groups. Subjects who were performing exercise showed significant increase in tcPO2 readings after 3 months (P<0.001), whereas the tcPO2 readings remained the same in the non-exercise groups.

CONCLUSIONS: We concluded that exercise had a significant effect on the VLU healing and this effect may be enhanced further with the help of the compression therapy. The tcPO2 and RF measurements may be seen as useful tools in evaluating the microvascular changes, and monitoring healing and follow up of the venous leg ulcer.