Adding Exercise to Compression for Venous Leg Ulcers: Does The Combination Increase Healing?
Venous leg ulcerations (VLU) occur with chronic venous insufficiency and lead to increased pain, impaired sleep, and reduced mobility. Typically, VLU is treated with compression (i.e. multi-layered bandages).
A recent review looked at whether adding prescribed exercises would have an impact on VLU healing. The authors identified 5 randomized clinical trials where both exercise and compression were prescribed and compared to compression alone. Exercises included progressive resistance exercises, such as heel raises or exercises with weights or body weight, and aerobic exercise such as daily walking.
The results showed that for the 190 patients with venous leg ulceration who participated in these studies, exercise was associated with increased healing rates compared to the control groups. The combination of progressive resistance exercise plus prescribed physical activity was associated with increased healing by 27 additional cases per 100 patients. The authors note that though the sample sizes were small, the evidence may be sufficient to suggest clinicians and suitable patients add simple progressive resistance exercises and walking to the treatment plan.
The authors conclude that the evidence base for incorporating exercise into VLU treatment is growing and even if the benefit is not as strongly associated in future studies, it is unlikely that adding exercise would disadvantage patients, given the overall benefits of physical activity.