Exercise fidelity and progression in a supervised exercise programme for adults with venous leg ulcers

Abstract

Despite exercise being included in the recommended advice for patients with venous leg ulcers, there is a fear shared by clinicians and patients that exercise may be either inappropriate or harmful and actually delay rather than promote healing. Therefore, before implementing a larger-scale study exploring the effects of a supervised exercise programme in patients with venous ulcers being treated with compression therapy, it is important to assess exercise safety as well as fidelity and progression in a feasibility study. Eighteen participants randomised in the exercise group were asked to undertake 36 (3 times/week for 12 weeks) 60-min exercise sessions, each comprising moderate-intensity aerobic, resistance, and flexibility exercise components. For the purposes of this paper, we analysed the data collected during the exercise sessions. The overall session attendance rate was 79%, with 13 of 18 participants completing all sessions. No in-session adverse events were reported; 100% aerobic components and 91% of resistance components were completed within the desired moderate-intensity target. Similarly, 81% of aerobic components and 93% of flexibility components were completed within the prescribed duration targets. Our data showed that patients with venous ulcers could safely follow a supervised exercise programme incorporating moderate-intensity aerobic, resistance, and flexibility components.

Effects of exercise in treating patients with venous leg ulcers: A systematic review and meta‐analysis

“…After excluding 135 duplicate studies and ineligible studies (77 reviews, 18 case reports, 3 animal studies, 18 conference abstracts, 172 irrelevant records), a total of 100 studies were evaluated for eligibility in the next step of screening. After full‐text review of 28 articles, we finally identified eight randomised control studies that met the inclusion criteria, including a total of 270 patients with diagnosed VLU 32‐39 . Details on literature search is depicted in Figure 1.…”

“…After full‐text review of 28 articles, we finally identified eight randomised control studies that met the inclusion criteria, including a total of 270 patients with diagnosed VLU. 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 Details on literature search is depicted in Figure 1 . The year of publication for included studies ranged from 2010 to 2022.…”

“…In the current meta-analysis, the pooled proportion of participants adherent to exercise regimen was 64% (95% CI: 53%, 75%), patients in these studies received clear direction and tutorials on exercise schedule and performance, and were supervised by investigators to improve the compliance with the regimens. [32][33][34]38 Moreover, results of evaluation for Egger's tests suggested nonsignificant publication bias in enrolled studies.…”

Examining the New-Member Effect to an Established Community-Based Physical Activity Program for Older Adults in England

“…The research team involved in the evaluative work did not have influence over the content of the sessions delivered, as this was an existing community-based Public Health initiative. A worthwhile aspect for the Vitality program would be to consider evaluating the exercise progression and fidelity of new but also existing members, which has occurred in other exercise interventions for older adults [ 43 ]. It should be acknowledged that whilst participants in both the VP and CON groups were instructed not to participate in any additional daily physical activity, this was not monitored during the study period.…”