Table. Characteristics of Included Studies.
| Study | Characteristics (IG vs CG) | Intervention | Frequency, Duration | Outcomes Reported in Trial | Funding, Trial Registration | Comments |
|---|---|---|---|---|---|---|
| Jull et al, 200924; New Zealand; home-based; unsupervised; 2-arm parallel group RCT |
No., 40; IG, 21; CG, 19; age, 54.6 years vs 53.3 yearsa; female, 16 vs 11; ABI, 1.1 vs 1.1a; ulcer area, 3.4 vs 3.1 cm2b |
Progressive resistance exercise in addition to compression: 3 sets of heel raises at 80% participant's maximum, represcribed by nurse at 3, 6, and 9 weeks after randomization. Compression type: multilayer bandaging (not specified) or hosiery. |
Alternate days; 12 weeks. |
Complete healing (proportion) at 12 weeks; time to complete healing; change in ulcer area; calf muscle pump function (air plethysmography); adverse events. |
Health Research Council of New Zealand. Austalia New Zealand Clinical Trials Register: ANZCTRN 12606000491561. |
Median ulcer area larger at baseline in exercise group than control group. Meets ACSM criteria for progressive exercise. |
| Meagher et al, 201225; Ireland; home-based; unsupervised; 2-arm parallel group RCT |
No., 35; IG, 18; CG, 17; age, 66.0 years vs 78.0 yearsb; female: 12 vs 13; ABI, 1.17 vs 1.0a; ulcer area (patients with area <10cm2): 17 vs 11 |
Prescribed walking with target of 10 000 steps per day. Compression type: not specified. |
Daily; 12 weeks. |
Complete healing at 12 weeks | None. Not registeredc |
More participants with ulcer area >10 cm2 in control group than exercise group. |
| O'Brien et al, 201326; Australia; home-based; unsupervised; 2-arm parallel group RCT |
No., 13; IG, 6; CG, 7; age, 66.0 years vs 63.6 yearsa; female, 3 vs 2; ABI, 1.05 vs 1.05a; ulcer area, 5.1 vs 3.2 cm2a |
Progressive resistance exercise in addition to compression: 3 sets of 10 then 15, then 20, then 25 repetitions of seated heel raises, progressing to standing heel raises and then 1-legged heel raises (with progression to next level on successful completion of current level for 3 days. Compression type: multilayer (not specified). |
Three times daily; 12 weeks. |
Complete healing at 12 weeks; calf muscle pump function (air plethysmography). |
Queensland University of Technology. Australia New Zealand Clinical Trials Register: ACTRN 12611000469910 |
Mean baseline ulcer area greater in exercise than control group. Meets ACSM criteria for progressive exercise. |
| O'Brien et al, 201727; Australia; home-based; unsupervised; 2-arm parallel group RCT |
No., 63; IG, 31; CG, 32; age, 71.3 years vs 71.7 yearsa; female, not reported by group; ABI, not reported; ulcer area: 8.8 vs 6.0 cm2a |
Progressive resistance exercise and walking in addition to compression: 3 sets of 10 then 15, then 20, then 25 reptitions of seated heel raises, progressing to standing heel raises and then 1-legged heel raises (with progression to next level on successful completion of current level for 3 days. Thirty minutes walking 3 times per week. Compression type: not specified (53% in compression >30 mm Hg). |
Three times daily for PRE and 3 times weekly for walking. | Complete healing at 12 weeks; health-related quality of life (SF-8). |
Queensland University of Technology. Australia New Zealand Clinical Trials Register: ACTRN 12612000475842 |
Mean baseline ulcer area greater in exercise than control group. Meets ACSM criteria for progressive exercise. |
| Klonizakis et al, 201728; England; gym-based; supervised; 2-arm parallel group RCT |
No., 39; IG, 18; CG, 21: age, 65.4 years vs 61.9 yearsa; female, 9 vs 7; ABI, 1.0 vs 1.1a; ulcer area, 4.9 vs 5.7 cm2b |
Resistance, aerobic and flexibility exercises in addition to compression: Resistance exercises predominantly bodyweight exercises with and without dumbells eg, calf raises and partial squats (2-3 sets of 10-15 repetitions), flexibility focused on ankle joint function and aerobic exercise consisted of 30 minutes treadmill and/or cycling depending on preference. Compression type: not specified. |
Three times per week. | Complete healing at 12 weeks, 6 months and 12 months; time to complete healing; health-related quality of life (EQ5D, VEINES-QOL); costs; adverse events. |
National Institute for Health Research. Current Controlled Trials: ISRCTN10205425 |
Meets ACSM criteria for progressive exercise. |
| Mutlak et al, 201829; home-based; unsupervised; 4-arm parallel group RCT (only pertinent 2 arms included herein) |
No., 40; IG, 20; CG, 20; age, 62.2 years vs 69.2 yearsa; female, 10 vs 10; ABI, not reported; ulcer area: 2.4 vs 2.5 cm2b |
Ten dorsiflexions hourly for every waking hour in addition to compression. Compression type: not specified |
Daily. | Change in ulcer area at 12 weeks. | Hammersmith Hospital. Not registered |
Ulcer area measured as maximum length times maximum width of reference ulcer. |
Abbreviations: ABI, Ankle-Brachial Index; ACSM, Americain College of Sports Medicine, CG, control group; EQ5D, EuorQol 5 D instrument; IG, intervention group; PRE, progressive resistance exercise; QOL, quality of life; RCT, randomized clinical trial; SF-8, Short Form 8 Question Instrument.
a
Mean.
b
Median.
c
Information provided by corresponding author.