Progressive resistance plus physical activity increases likelihood that venous leg ulcers will heal

Référence

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.

Sommaire

This was a meta-analysis for the Cochrane Collaboration. The authors identified randomized trials that compared exercise with no intervention or sham therapy in patients with a venous leg ulcer, all of whom were also receiving compression therapy. The authors initially identified 519 studies, reviewed the full text of 33, and included 6 studies with 230 patients in their study. The primary threat to validity was a failure to mask outcome assessors in 4 of the 6 studies.The studies recommended one of the following: walking of 10,000 steps per day, resistance exercises, ankle exercises, or progressive resistance exercise plus prescribed physical activity. There was no benefit to progressive resistance exercise (2 studies) or walking 10,000 steps alone (1 study). However, the combination of progressive resistance exercise plus physical activity, reported in 2 studies with a total of 152 patients, led to a statistically and clinically significant improvement in ulcer healing of 27 percentage points (95% CI 9% - 45%). Adverse events were uncommon and not serious when reported.