European journal of applied physiology · 2017
Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Tew Garry A, Gumber Anil, McIntosh Emma, Kesterton Sue, King Brenda, Michaels Jonathan A, Klonizakis Markos
Аннотация
PURPOSE: To investigate the effects of a 12-week supervised exercise programme on lower-limb cutaneous microvascular reactivity in adults with venous leg ulceration.
METHODS: Thirty-eight adults with unilateral venous ulceration who were being treated with lower-limb compression therapy (58% male; mean age 65 years; median ulcer size 5 cm2) were randomly allocated to exercise or control groups. Exercise participants (n = 18) were invited to attend thrice weekly sessions of lower-limb aerobic and resistance exercise for 12 weeks. Cutaneous microvascular reactivity was assessed in the gaiter region of ulcerated and non-ulcerated legs at baseline and 3 months using laser Doppler fluxmetry coupled with iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). Cutaneous vascular conductance (CVC) was calculated as laser Doppler flux (AU)/mean arterial pressure (mmHg).
RESULTS: Thirty-seven participants completed follow-up assessments. Median session attendance was 36 (range 2-36). Analyses of covariance revealed greater peak CVC responses to ACh in the exercise group at 3 months in both the ulcerated (adjusted difference = 0.944 AU/mmHg; 95% CI 0.504-1.384) and non-ulcerated (adjusted difference = 0.596 AU/mmHg; 95% CI 0.028-1.164) legs. Peak CVC responses to SNP were also greater in the exercise group at 3 months in the ulcerated leg (adjusted difference = 0.882 AU/mmHg; 95% CI 0.274-1.491), but not the non-ulcerated leg (adjusted difference = 0.392 AU/mmHg; 95% CI - 0.377 to 1.161).
CONCLUSION: Supervised exercise training improves lower-limb cutaneous microvascular reactivity in adults with venous leg ulceration.
METHODS: Thirty-eight adults with unilateral venous ulceration who were being treated with lower-limb compression therapy (58% male; mean age 65 years; median ulcer size 5 cm2) were randomly allocated to exercise or control groups. Exercise participants (n = 18) were invited to attend thrice weekly sessions of lower-limb aerobic and resistance exercise for 12 weeks. Cutaneous microvascular reactivity was assessed in the gaiter region of ulcerated and non-ulcerated legs at baseline and 3 months using laser Doppler fluxmetry coupled with iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). Cutaneous vascular conductance (CVC) was calculated as laser Doppler flux (AU)/mean arterial pressure (mmHg).
RESULTS: Thirty-seven participants completed follow-up assessments. Median session attendance was 36 (range 2-36). Analyses of covariance revealed greater peak CVC responses to ACh in the exercise group at 3 months in both the ulcerated (adjusted difference = 0.944 AU/mmHg; 95% CI 0.504-1.384) and non-ulcerated (adjusted difference = 0.596 AU/mmHg; 95% CI 0.028-1.164) legs. Peak CVC responses to SNP were also greater in the exercise group at 3 months in the ulcerated leg (adjusted difference = 0.882 AU/mmHg; 95% CI 0.274-1.491), but not the non-ulcerated leg (adjusted difference = 0.392 AU/mmHg; 95% CI - 0.377 to 1.161).
CONCLUSION: Supervised exercise training improves lower-limb cutaneous microvascular reactivity in adults with venous leg ulceration.