Association between physical activity levels and healing in people with venous leg ulcers: secondary analysis of prospective cohort data

Yunjing Qiu; Christian R Osadnik; Natasha K Brusco; Geoffrey Sussman; Judy Reeves; Leanne Gleghorn; Carolina D Weller; Victoria Team

doi:10.3389/fmed.2023.1305594

Association between physical activity levels and healing in people with venous leg ulcers: secondary analysis of prospective cohort data

Front Med (Lausanne). 2023 Dec 21:10:1305594. doi: 10.3389/fmed.2023.1305594. eCollection 2023.

Authors

Yunjing Qiu^{1

2}, Christian R Osadnik³, Natasha K Brusco⁴, Geoffrey Sussman^{5

6}, Judy Reeves⁷, Leanne Gleghorn⁸, Carolina D Weller², Victoria Team²

Affiliations

¹ School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia.
² School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia.
³ Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia.
⁴ Rehabilitation, Ageing and Independent Living Research Centre, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia.
⁵ Austin Health, Melbourne, VIC, Australia.
⁶ Department of General Practice Faculty of Medicine, Nursing and Health Science Monash University, Melbourne, VIC, Australia.
⁷ Alfred Health, Melbourne, VIC, Australia.
⁸ Cabrini Hospital, Malvern, Melbourne, VIC, Australia.

Abstract

Aim: To explore the relationship between physical activity levels and wound healing and recurrence in people with venous leg ulcers.

Methods: Questionnaires and medical records were used to collect data, with responses used to group participants into different physical activity groups. The differences in healing and recurrence outcomes of ulcers among different physical activity groups were compared using Chi-square, Kaplan Meier survival analysis, Cox proportional hazards regression analysis, and Kruskal-Wallis test. To measure the strength of the association between physical activity levels and patient outcomes, Spearman's Rho tests were used. We used descriptive analysis to examine how physical activity levels change over 24 weeks.

Results: Participants were classified into four distinct groups based on physical activity levels reported at baseline and week 12. The survival analysis showed higher physical activity level was associated with a shorter time to healing (log-rank test = 14.78, df = 3; p = 0.002). The persistently moderate-to-vigorous group had a 7.3-fold increased likelihood of healing compared to the persistently sedentary group. High levels of physical activity were also associated with a better quality of life score at baseline ( $ρ$ = 0.41, p < 0.000), week 12 ( $ρ$ = 0.36, p < 0.001), and week 24 ( $ρ$ = 0.49, p < 0.000). Most participants (48.5%) reported low levels of physical activity, which remained low for the entire study period.

Conclusion: An increased level of physical activity was linked to a shorter healing time and enhanced quality of life. Low levels of physical activity appeared common among people with venous leg ulcers.

Keywords: adjuvant treatment; healing; physical activity level; recurrence; varicose ulcer.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. YQ was the recipient of the graduate research scholarship from Monash University for conducting the present work. YQ was the recipient of the Open Access Grant from the University of Technology Sydney for publishing this article. The ASPiVLU clinical trial has received financial support from the National Health and Medical Research Council (NHMRC) (APP1069329). This research was supported by an Australian Government Research Training Program.