Jull A, Parag V, Walker N, Maddison R, Kerse N, Johns T
School of Nursing University of Auckland, New Zealand. ajull2@auckland .ac.nz
J Wound Care. 2009 Dec;18(12):497-503. doi: 10.12968/jowc.2009.18.12.45606.
To establish the feasibility of conducting a home-based progressive resistance exercise programme to improve calf muscle pump function in community-based patients with venous leg ulcers.
Participants were randomised to receive a 12-week progressive resistance exercise programme using heel raises in addition to compression. The control was usual care in addition to compression. Randomisation was stratified by ulcer duration and ulcer size. Air plethysmography was used to determine changes in calf muscle pump function from baseline. Changes in ulcer parameters were measured using the SilhouetteMobile device.
Forty participants were randomised. There were significantly greater improvements in ejection fraction of the calf muscle in the exercise group compared with the control (usual care) group (mean difference 18.5%, 95% CI 0.03 to 36.6%, p<0.05). Other parameters improved in the exercise group but the mean differences were not significant. Adherence with prescribed exercises was 81% and there was no significant difference in the numbers reporting adverse events. There were also no significant differences in ulcer healing parameters (change in area, percentage change in area, number healed at 12 weeks, time to healing).
A community-based randomised trial of progressive resistance exercise is feasible. The prescribed exercises appeared to increase ejection fraction, but the effect of exercise on ulcer healing requires further investigation.
确定开展一项居家渐进性抗阻运动计划以改善社区静脉性腿部溃疡患者小腿肌肉泵功能的可行性。
参与者被随机分为两组，一组除接受加压治疗外，还进行为期12周的使用提踵动作的渐进性抗阻运动计划；对照组除加压治疗外接受常规护理。随机分组按溃疡持续时间和溃疡大小进行分层。采用空气容积描记法确定小腿肌肉泵功能相对于基线的变化。使用SilhouetteMobile设备测量溃疡参数的变化。
40名参与者被随机分组。与对照组（常规护理组）相比，运动组小腿肌肉的射血分数有显著更大的改善（平均差异18.5%，95%可信区间0.03至36.6%，p<0.05）。运动组的其他参数有所改善，但平均差异不显著。规定运动的依从率为81%，报告不良事件的人数没有显著差异。溃疡愈合参数（面积变化、面积变化百分比、12周时愈合的数量、愈合时间）也没有显著差异。
一项基于社区的渐进性抗阻运动随机试验是可行的。规定的运动似乎增加了射血分数，但运动对溃疡愈合的影响需要进一步研究。
