Physical activity, sleep and wound healing in adults with venous leg ulcers: a prospective observational cohort pilot study protocol

Background: Adults with venous leg ulcers (VLUs) are less likely to be physically active and show greater sleep disturbances than the general population. Limited evidence suggests these issues contribute to VLU healing delays.Objectives: The primary objective is to determine if physical activity (PA) and sleep levels are associated with VLU healing. The secondary objectives are to: 1) evaluate the feasibility and acceptability of a wrist-worn accelerometer device, wActiSleep-BT device wear (ActiGraph); 2) evaluate the utility of self-reported PA instruments to measure PA for people with VLU; and 3) determine whether PA and sleep levels are associated with i) delayed healing, ii) self-reported quality of life (QoL) and/or iii) self-reported VLU pain.Design and method: This prospective observational cohort pilot study aims to recruit 30 adults with VLUs from three hospital-based outpatient wound clinics in Melbourne, Australia. PA and sleep levels will be measured using the wActiSleep-BT device. VLU healing data will be collected from medical records. Patients’ self-reported outcomes will be collected using questionnaires.Discussion: Findings will provide insight into the relationship between PA and sleep with healing, QoL and pain, and determine the feasibility and acceptability of the wActiSleep-BT device. Findings will also inform the potential utility of self-reported instruments in estimating PA level in people with VLUs.Contribution of the paper statements:What is already known about the topic?VLUs are a common and costly problem. Adults with VLUs are more likely to be inactive. Sleep disturbances are more common in adults with VLUs than the general population. Increased PA may improve wound healing outcomes for adults with VLUs. What this paper adds An objective evaluation of the level of PA and sleep by adults with VLUs. The relationship between PA, sleep, VLU healing, as well as QoL and pain. The validation of self-reported instruments for assessing PA level. A feasibility assessment of the wActiSleep-BT device to examine levels of PA and sleep in adults with VLUs. An acceptability assessment of wearing the wActiSleep-BT device by adults with VLUs.