Venous leg ulcers (VLUs) are a common and costly problem worldwide with an increasing health care cost burden due to an ageing population and the growing epidemic of diabetes and obesity. VLUs have a considerable impact on individual’s health, quality of life and socioeconomic costs.
Little is known about the role of physical activity in influencing venous leg ulcer (VLU) onset or healing outcomes. VLU sufferers are more likely to be sedentary than age-matched controls and are less mobile with greater dependence on walking aids and transportation. Increased physical activity may improve wound healing outcomes for adults with venous leg ulceration by improving calf muscle function and ankle mobility which are essential biomechanical actions for improving the circulatory pump action of the lower limb and reducing venous pooling. Sleep disturbances are more common in VLU patients than the general population. Sleep is essential for processes of rest, recovery and wound healing and even mild sleep disruption is known to impair immunity and consequently wound healing by disrupting macrophage and lymphocyte production. Impaired sleep can impact on energy levels with good sleep quality predicting higher levels of physical activity the next day in persons with persistent pain.
There is paucity of research investigating the relationship between physical activity (including sleep) and healing outcomes in VLU patients. We will investigate the relationship with VLU healing and physical activity levels (and sleep patterns) with the ActiSleep-BT accelerometer (ActiGraph, Pensacola, Florida) (accelerometer) to inform clinical practice guidelines.
Accelerometers provide reliable, objective measurements of human activity and are used in many research and clinical applications. Wearing an accelerometer on the wrist will assist with compliance in wear time and has been reported as an accurate location for activity measurement.
We will conduct a physical activity observational cohort study in parallel with the ASPiVLU (ASPirin in Venous Leg Ulcer) Observational Cohort Study currently in progress which is collecting medical record data and patient questionnaires. The physical activity observational cohort study will examine association of physical activity (including sleep patterns) with time to healing and recurrence rates in people VLUs using the accelerometer.
This proposed proof of concept study will test the methodology, recruitment feasibility, participant accelerometer acceptability to inform a large scale national clinical trial.