Sedentary patients with venous or mixed leg ulcers: determinants of physical activity

This paper is a report of a study to identify the determinants of physical activity (PA) in patients with venous leg ulcers to develop recommendations for behavioural interventions aimed at enhancing physical activity.

Physical activity promotes wound healing and prevents the recurrence of wounds in venous patients with leg ulcers. Many patients with leg ulcers, however, have a sedentary lifestyle.

A random sample of 25 patients from two clinics were interviewed in 2003 using a combination of prestructured and open-ended questions. All these patients were being treated at an outpatient dermatology clinic and had a leg ulcer with venous or mixed aetiology at the time of the interview or in the month prior to the interview.

Only nine of the 25 patients (36%) reported sufficient levels of moderate strenuous physical activity, defined as 30 minutes a day on at least 5 days a week. The results show limited knowledge about the relationship between physical activity and leg ulceration, and low self-efficacy for increasing physical activity. In addition, multi-morbidity, pain and social support were identified as main determinants of physical activity.

Suggestions for improving physical activity levels include influencing knowledge, beliefs and self-efficacy. Patient's individual physical limitations, pain, adequate footwear and social support should be taken into account. Programmes offered by specialized dermatology nurses to stimulate physical activity might fulfil patient needs and help enhance physical activity levels.