ABSTRACT
Compression bandaging is the mainstay therapy for chronic venous insufficiency and venous leg ulcers, but patient compliance can be challenging due to associated discomfort. The study discussed here aimed to compare AndoFlex TLC Calamine and Coban2 compression bandaging in relation to patient comfort and pruritus symptomology, with severity of pruritus as the primary outcome. This was a multi-centre, prospective, non-blinded, randomised controlled crossover trial involving 39 randomised patients with chronic venous insufficiency patients. In two periods, the patients wore AndoFlex TLC Calamine or Coban2 for 3 weeks each. No significant differences in validated pruritus outcome measures were observed, including a non-significant treatment effect for the severity of pruritus scale (n=35 trial completers; p-value=0.24, Wilcoxon test). However, after trying both bandages, 21 of the 35 patients (60%) definitely preferred AndoFlex TLC Calamine, whereas 4 patients (11%) definitely preferred Coban2. Thus, AndoFlex TLC Calamine compression bandage therapy was preferred by most patients, although this observation could not be confirmed using validated patient-reported outcome measures for pruritus. Further research is indicated to establish if patient preference translates into favourable clinical outcomes. ISRCTN number: ISRCTN95282887.
Subject(s)
Compression Bandages , Venous Insufficiency/therapy , Aged , Aged, 80 and over , Cross-Over Studies , Female , Humans , Male , Middle Aged , Prospective Studies , Pruritus , Varicose Ulcer/therapy , Wound HealingSubject(s)
Resistance Training , Varicose Ulcer , Aged , Aged, 80 and over , Feasibility Studies , Female , Humans , Male , Prospective Studies , Varicose Ulcer/physiopathology , Varicose Ulcer/therapyABSTRACT
OBJECTIVES: To determine if the use of a plantar flexion device (Step It pedal) in a newly developed exercise programme is of benefit to patients with peripheral arterial disease. DESIGN: Prospective feasibility trial with patients randomised to either standard care or the Step It exercise programme plus standard care. SETTING: Physiotherapy Department at Cumberland Infirmary, Carlisle, UK. PARTICIPANTS: Patients were identified from the vascular team's referral list. In total, 42 patients agreed to take part; 18 in the control group and 24 in the intervention group. INTERVENTIONS: Eligible participants were randomised and received either standard care or took part in a plantar flexion resistance exercise programme, involving the Step It pedal, for a period of 12 weeks. MAIN OUTCOME MEASURES: Maximum walking distance, claudication distance and ankle brachial pressure index. RESULTS: Eighty-three percent of patients completed the study. Improvements in median distance to claudication symptoms and maximum walking distance were observed in the intervention group but not in the control group. Nine out of 15 (60%) participants in the control group and 14 out of 20 (70%) participants in the intervention group improved their walking distance. Ankle brachial pressure index remained virtually unchanged in both groups. CONCLUSIONS: Due to the variability of patients' fitness in the sample, it cannot be concluded whether use of the Step It pedal has additional benefits to patients over standard care. However, the study completion rate implies that patients with peripheral arterial disease are receptive to undertaking exercise programmes.
