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Title: The influence of exercise on ulcer healing in patients with chronic venous insufficiency
Author: Mutlak, Omar Oubied
ISNI:       0000 0004 7969 7903
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2017
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Venous leg ulcer (VLU) is a common chronic clinical problem and it is the most serious complication of chronic venous insufficiency. Although venous ulcer has a huge burden on individuals and states, the standard type of treatment for this debilitating condition, compression therapy, has not changed in the last 2000 years. There is growing evidence that exercise could help in venous ulcer management. This study investigated the effect of exercise on 80 VLU patients. These patients were randomised into four groups; a control group, a compression therapy only group, an exercise only group and a compression and exercise group. Non-invasive measurements were performed at the beginning of the 3 month period of regular exercise, and again at the end of the exercise period. This was necessary in order to evaluate the effect of exercise on VLU healing parameters, which include; tcPO2 level, laser Doppler measurements, resting skin flux (RF), range of ankle joint movement (ROM) and ulcer size. The exercise composed of 10 dorsiflexions each hour, while the participant was awake over a period of 3 months. Findings included, an increase in the tcPO2 level and range of ankle joint movement in individuals who had performed the exercise compared to those who did not (p < 0.001). Moreover tcPO2 measurements were higher in the exercise and compression group than those seen in the exercise only group. Ulcer size and RF measurements decreased in patients who had performed exercise compared to those who did not, groups 3 and 4 showed a significant decrease in ulcer size with p values = 0.001 and < 0.001 respectively. With RF measurements, only groups 3 and 4 showed significant decrease, p < 0.001. The findings indicated that there were changes in the VLU parameters in response to the 3 months period of regular exercise. Regular unsupervised exercise may be included as an integral part of the leg ulcer management.
Supervisor: Aslam, Mohammed ; Standfield, Nigel Sponsor: Imperial College London
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral