Background

Venous leg ulceration is caused by chronic venous insufficiency and affects millions of adults worldwide who suffer prolonged healing episodes and due to underlying pathophysiology ulcer recurrence is common after healing. Compression therapy is the current best practice for managing venous leg ulcer since it provides constant pressure, which promotes circulation in the lower limbs. Nevertheless, the healing outcomes of venous leg ulcer vary considerably. Physical activity may be an effective adjunct treatment to improve ulcer healing outcomes. However, a low level of physical activity level is observed in this cohort.

Objective

To identify the barriers and enablers that affect physical activity participation in people with venous leg ulcers.

Design

A systematic review of qualitative studies using the mega-aggregation approach.

Methods

We followed the Joanna Briggs Institute methodology for systematic reviews of qualitative evidence. We searched MEDLINE, CINAHL PLUS, PsycINFO and Emcare to identify relevant articles published in English from 1806 to January 2021. Two reviewers independently screened and selected articles against inclusion criteria. Eligible studies were appraised for methodological quality using Joanna Briggs Institute Critical Appraisal tool. Qualitative data were extracted manually. Theoretical Domain Framework was used to map barriers and enablers to physical activity participation.

Results

Eighteen studies were included in this review. The main barriers and enablers identified in this review that influence physical activity engagement in people with venous leg ulcers are as follows: understanding the chronic nature of venous leg ulcers and the reasons for undertaking physical activities; specific beliefs that people hold about their own capabilities; pain related to wound and compression therapy; information and supports received from treating clinicians; feeling of fear and embarrassment. The confidence level for most of the synthesis findings was moderate to low.

Conclusions

Our review identified people with venous leg ulcers experience significant challenges preventing them from engaging in physical activity. Factors such as knowledge of physical activity, availability of information, and self-belief may be particularly important for promoting physical activity in this cohort. Future interventions are recommended to provide educational information and clear instructions to improve participation. Further research is needed to explore potential interventions that may change physical activity behaviour in this population group.

Registration

PROSPERO CRD42021238579

中文翻译：

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腿部静脉性溃疡患者身体活动的障碍和促进因素：对定性研究的系统评价

背景

腿部静脉溃疡是由慢性静脉功能不全引起的，影响着全世界数百万患有长期愈合期的成年人，并且由于潜在的病理生理学原因，愈合后溃疡复发很常见。加压疗法是目前治疗腿部静脉溃疡的最佳实践，因为它提供恒定的压力，促进下肢循环。然而，静脉性腿部溃疡的愈合结果差异很大。体育锻炼可能是改善溃疡愈合结果的有效辅助治疗。然而，在该队列中观察到低水平的体力活动水平。

客观的

确定影响腿部静脉性溃疡患者身体活动参与的障碍和促成因素。

设计

使用巨型聚合方法对定性研究进行系统评价。

方法

我们遵循乔安娜布里格斯研究所的方法对定性证据进行系统评价。我们检索了 MEDLINE、CINAHL PLUS、PsycINFO 和 Emcare，以确定 1806 年至 2021 年 1 月期间以英语发表的相关文章。两名审稿人根据纳入标准独立筛选和选择文章。使用 Joanna Briggs Institute 批判性评估工具对符合条件的研究进行方法学质量评估。手动提取定性数据。理论领域框架用于绘制身体活动参与的障碍和促成因素。

结果

本综述纳入了 18 项研究。本综述中确定的影响腿部静脉性溃疡患者身体活动参与的主要障碍和促成因素如下：了解腿部静脉性溃疡的慢性性质以及进行身体活动的原因；人们对自己能力的特定信念；与伤口和压迫疗法有关的疼痛；从治疗临床医生那里获得的信息和支持；恐惧和尴尬的感觉。大多数综合结果的置信水平为中等至低。

结论

我们的审查确定了患有静脉性腿部溃疡的人在阻止他们进行体育活动时遇到了重大挑战。诸如身体活动知识、信息可用性和自信心等因素对于促进该人群的身体活动可能特别重要。建议未来的干预措施提供教育信息和明确的指示，以提高参与度。需要进一步的研究来探索可能改变该人群身体活动行为的潜在干预措施。

登记

PROSPERO CRD42021238579