title: A home-based exercise programme improves ankle range of motion in long-term venous ulcer patients.
abstract: OBJECTIVE
  Decreased ankle mobility is associated with delayed healing of venous ulcers. The aim of this study was to assess the efficacy of a 24-week home-based exercise programme in increasing ankle range of motion and increasing the strength and endurance of the calf muscle. The secondary aim was to see whether subjects with venous ulcers were able to maintain a consistent exercise programme.
  
  
  METHODS
  Eleven patients with long-standing venous ulcers were encouraged to undertake a thrice-weekly 5-10 min ankle exercise programme using elastic resistance bands and stretching in a 24-week single-arm pilot study. Ankle range of motion was measured monthly using a bi-plane ankle goniometer. Pain scores and participation levels were also recorded.
  
  
  RESULTS
  There were significant improvements in ankle range of motion achieved at 12 and 24 weeks. Median pain scores (scale of 1-10) were reduced from 5.2 at baseline to 2.0 at weeks 12 and 24.
  
  
  CONCLUSIONS
  These results show that a simple, home-based exercise programme is effective in achieving gains in ankle range of motion and may help to reduce pain. Good participation levels show that it is not only effective, but also feasible. A larger randomized controlled study is needed to show whether there is a positive effect on ulcer healing.
authors.affiliation: East London Wound Healing Centre, Mile End Hospital, Tower Hamlets Primary Care Trust, London, UK. judy.davies@thpct.nhs.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Davies
authors.forename: R H
authors.initials: RH
authors.lastname: Bull
authors.forename: I J
authors.initials: IJ
authors.lastname: Farrelly
authors.forename: M J
authors.initials: MJ
authors.lastname: Wakelin
mesh_terms: D000368:Aged; D000843:Ankle Joint / Q000503:physiopathology*; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D010349:Patient Compliance; D010865:Pilot Projects; D016059:Range of Motion, Articular; D013997:Time Factors; D016896:Treatment Outcome; D014647:Varicose Ulcer / Q000150:complications / Q000503:physiopathology / Q000628:therapy*