Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers
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; mea...
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| Veröffentlicht in: | European journal of applied physiology 2018-02, Vol.118 (2), p.321-329 |
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| creator | Tew, Garry A. Gumber, Anil McIntosh, Emma Kesterton, Sue King, Brenda Michaels, Jonathan A. Klonizakis, Markos |
| description | 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 cm
2
) 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. |
| doi_str_mv | 10.1007/s00421-017-3772-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5767192</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1972307344</sourcerecordid><originalsourceid>FETCH-LOGICAL-c518t-75bd9549bc77c58242e1176e1e534d7b05eecf407d4db352216cbcb521f555213</originalsourceid><addsrcrecordid>eNp1kU1v1DAQhi0Eoh_wA7ggS1y4BDz-WG8uSKgqFKkSFzhbjjPZunKcxY7T9t_jVcqqIHGxR5pnXvudl5A3wD4AY_pjZkxyaBjoRmjNG_aMnIIUbbMRXD8_1tCekLOcbxljWw7bl-SEt9DqVsApKZfDgG7OdBpoLntMi8_YU7zH5GpF52R99HFHp0jDdIepCX7sqCuzjTiVTEfv0rTY7EqwiSa0bvaLnx-oj9T2JVTpOz_f0AXjAS_BYcqvyIvBhoyvH-9z8vPL5Y-Lq-b6-9dvF5-vG6dgOzdadX2rZNs5rZ3acskRQG8QUAnZ644pRDdIpnvZd0JxDhvXuU5xGJSqpzgnn1bdfelG7B3G6ieYffKjTQ9mst783Yn-xuymxSi90dDyKvD-USBNvwrm2Yw-OwxhdW_qGrlgWkhZ0Xf_oLdTSbHaO1AAEoRqKwUrVbeWc8Lh-Blg5hCqWUM1NVRzCNWwOvP2qYvjxJ8UK8BXINdW3GF68vR_VX8D6xCvsg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1971141359</pqid></control><display><type>article</type><title>Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Tew, Garry A. ; Gumber, Anil ; McIntosh, Emma ; Kesterton, Sue ; King, Brenda ; Michaels, Jonathan A. ; Klonizakis, Markos</creator><creatorcontrib>Tew, Garry A. ; Gumber, Anil ; McIntosh, Emma ; Kesterton, Sue ; King, Brenda ; Michaels, Jonathan A. ; Klonizakis, Markos</creatorcontrib><description>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 cm
2
) 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.</description><identifier>ISSN: 1439-6319</identifier><identifier>EISSN: 1439-6327</identifier><identifier>DOI: 10.1007/s00421-017-3772-0</identifier><identifier>PMID: 29197931</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acetylcholine ; Aged ; Biomedical and Life Sciences ; Biomedicine ; Blood pressure ; Compression ; Compression therapy ; Conductance ; Exercise ; Exercise Therapy - adverse effects ; Exercise Therapy - methods ; Female ; Fitness training programs ; Human Physiology ; Humans ; Iontophoresis ; Leg ; Lower Extremity - blood supply ; Male ; Microvasculature ; Microvessels - physiopathology ; Middle Aged ; Occupational Medicine/Industrial Medicine ; Original ; Original Article ; Regional Blood Flow ; Skin - blood supply ; Sodium ; Sodium nitroprusside ; Sports Medicine ; Ulcers ; Varicose Ulcer - therapy</subject><ispartof>European journal of applied physiology, 2018-02, Vol.118 (2), p.321-329</ispartof><rights>The Author(s) 2017</rights><rights>European Journal of Applied Physiology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-75bd9549bc77c58242e1176e1e534d7b05eecf407d4db352216cbcb521f555213</citedby><cites>FETCH-LOGICAL-c518t-75bd9549bc77c58242e1176e1e534d7b05eecf407d4db352216cbcb521f555213</cites><orcidid>0000-0002-8610-0613</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00421-017-3772-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00421-017-3772-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29197931$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tew, Garry A.</creatorcontrib><creatorcontrib>Gumber, Anil</creatorcontrib><creatorcontrib>McIntosh, Emma</creatorcontrib><creatorcontrib>Kesterton, Sue</creatorcontrib><creatorcontrib>King, Brenda</creatorcontrib><creatorcontrib>Michaels, Jonathan A.</creatorcontrib><creatorcontrib>Klonizakis, Markos</creatorcontrib><title>Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers</title><title>European journal of applied physiology</title><addtitle>Eur J Appl Physiol</addtitle><addtitle>Eur J Appl Physiol</addtitle><description>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 cm
2
) 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.</description><subject>Acetylcholine</subject><subject>Aged</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood pressure</subject><subject>Compression</subject><subject>Compression therapy</subject><subject>Conductance</subject><subject>Exercise</subject><subject>Exercise Therapy - adverse effects</subject><subject>Exercise Therapy - methods</subject><subject>Female</subject><subject>Fitness training programs</subject><subject>Human Physiology</subject><subject>Humans</subject><subject>Iontophoresis</subject><subject>Leg</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Microvasculature</subject><subject>Microvessels - physiopathology</subject><subject>Middle Aged</subject><subject>Occupational Medicine/Industrial Medicine</subject><subject>Original</subject><subject>Original Article</subject><subject>Regional Blood Flow</subject><subject>Skin - blood supply</subject><subject>Sodium</subject><subject>Sodium nitroprusside</subject><subject>Sports Medicine</subject><subject>Ulcers</subject><subject>Varicose Ulcer - therapy</subject><issn>1439-6319</issn><issn>1439-6327</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kU1v1DAQhi0Eoh_wA7ggS1y4BDz-WG8uSKgqFKkSFzhbjjPZunKcxY7T9t_jVcqqIHGxR5pnXvudl5A3wD4AY_pjZkxyaBjoRmjNG_aMnIIUbbMRXD8_1tCekLOcbxljWw7bl-SEt9DqVsApKZfDgG7OdBpoLntMi8_YU7zH5GpF52R99HFHp0jDdIepCX7sqCuzjTiVTEfv0rTY7EqwiSa0bvaLnx-oj9T2JVTpOz_f0AXjAS_BYcqvyIvBhoyvH-9z8vPL5Y-Lq-b6-9dvF5-vG6dgOzdadX2rZNs5rZ3acskRQG8QUAnZ644pRDdIpnvZd0JxDhvXuU5xGJSqpzgnn1bdfelG7B3G6ieYffKjTQ9mst783Yn-xuymxSi90dDyKvD-USBNvwrm2Yw-OwxhdW_qGrlgWkhZ0Xf_oLdTSbHaO1AAEoRqKwUrVbeWc8Lh-Blg5hCqWUM1NVRzCNWwOvP2qYvjxJ8UK8BXINdW3GF68vR_VX8D6xCvsg</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Tew, Garry A.</creator><creator>Gumber, Anil</creator><creator>McIntosh, Emma</creator><creator>Kesterton, Sue</creator><creator>King, Brenda</creator><creator>Michaels, Jonathan A.</creator><creator>Klonizakis, Markos</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8610-0613</orcidid></search><sort><creationdate>20180201</creationdate><title>Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers</title><author>Tew, Garry A. ; Gumber, Anil ; McIntosh, Emma ; Kesterton, Sue ; King, Brenda ; Michaels, Jonathan A. ; Klonizakis, Markos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c518t-75bd9549bc77c58242e1176e1e534d7b05eecf407d4db352216cbcb521f555213</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acetylcholine</topic><topic>Aged</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood pressure</topic><topic>Compression</topic><topic>Compression therapy</topic><topic>Conductance</topic><topic>Exercise</topic><topic>Exercise Therapy - adverse effects</topic><topic>Exercise Therapy - methods</topic><topic>Female</topic><topic>Fitness training programs</topic><topic>Human Physiology</topic><topic>Humans</topic><topic>Iontophoresis</topic><topic>Leg</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Microvasculature</topic><topic>Microvessels - physiopathology</topic><topic>Middle Aged</topic><topic>Occupational Medicine/Industrial Medicine</topic><topic>Original</topic><topic>Original Article</topic><topic>Regional Blood Flow</topic><topic>Skin - blood supply</topic><topic>Sodium</topic><topic>Sodium nitroprusside</topic><topic>Sports Medicine</topic><topic>Ulcers</topic><topic>Varicose Ulcer - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tew, Garry A.</creatorcontrib><creatorcontrib>Gumber, Anil</creatorcontrib><creatorcontrib>McIntosh, Emma</creatorcontrib><creatorcontrib>Kesterton, Sue</creatorcontrib><creatorcontrib>King, Brenda</creatorcontrib><creatorcontrib>Michaels, Jonathan A.</creatorcontrib><creatorcontrib>Klonizakis, Markos</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of applied physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tew, Garry A.</au><au>Gumber, Anil</au><au>McIntosh, Emma</au><au>Kesterton, Sue</au><au>King, Brenda</au><au>Michaels, Jonathan A.</au><au>Klonizakis, Markos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers</atitle><jtitle>European journal of applied physiology</jtitle><stitle>Eur J Appl Physiol</stitle><addtitle>Eur J Appl Physiol</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>118</volume><issue>2</issue><spage>321</spage><epage>329</epage><pages>321-329</pages><issn>1439-6319</issn><eissn>1439-6327</eissn><abstract>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 cm
2
) 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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29197931</pmid><doi>10.1007/s00421-017-3772-0</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8610-0613</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1439-6319 |
| ispartof | European journal of applied physiology, 2018-02, Vol.118 (2), p.321-329 |
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| language | eng |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Acetylcholine Aged Biomedical and Life Sciences Biomedicine Blood pressure Compression Compression therapy Conductance Exercise Exercise Therapy - adverse effects Exercise Therapy - methods Female Fitness training programs Human Physiology Humans Iontophoresis Leg Lower Extremity - blood supply Male Microvasculature Microvessels - physiopathology Middle Aged Occupational Medicine/Industrial Medicine Original Original Article Regional Blood Flow Skin - blood supply Sodium Sodium nitroprusside Sports Medicine Ulcers Varicose Ulcer - therapy |
| title | Effects of supervised exercise training on lower-limb cutaneous microvascular reactivity in adults with venous ulcers |
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