I have just been talking to a research student who asked me the question
'Is there any indication of the level of dorsi and plantar flexion that is
necessary in order to maintain reasonable tissue nutrition in older subjects?'
She was particularly interested in healing of venous leg ulcers and in the
maintainence of tissue viability there after.
I recall, many years ago, hearing physiotherapists instructing patients to
undertake 5 minutes of vigorous dorsi and plantar flexion every hour of their
waking day in order to maintain good levels of peripheral circulation. I would
be interested in knowing if anyone knows of any research that might
support this advice or provide more a more reliable basis for practice.
The student also asked me if I knew what might be the minimum amount of
functional activity that an elderly person might be advised to undertake in
order to maintain the viability of skin over the site of a healed leg ulcer.
She was thinking along the lines of percentage of waking day that might have to
be spent in moving around the house, or more simply, how many times might they
need to get out of their chair and move about in order to maintain fairly
adequate circulation.
I don't know the answers and I realise that these questions are fraught because
of the number of factors other than activity levels that might impinge on
peripheral circulation and tissue viability.
However if anyone has any scientific basis for advice on functional
activity that might be given to an older person who is fairly imobile and in
danger of tissue breakdown, I would be interested to know.
The student did a very limited search on medline but was not successful and as
this is not an area of my expertise I am not in a position to guide her to
those journals which might contain relevant research articles. I would be
grateful if anyone could save us time by pointing us in the right direction.
Thanks in anticipation
Marion Trew
Director of Physiotherapy Development
Oxford Brookes University
Oxford
UK
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