Barriers and enablers to physical activity participation in patients with venous leg ulcers: a systematic review protocol of qualitative evidence

Objective: The objective of this review is to synthesize available qualitative evidence to provide an overview of the barriers and enablers that influence physical activity participation in patients with venous leg ulcers. Introduction: Management of venous leg ulcers is a costly and time-consuming process in clinical settings due to the protracted healing process. Physical activity may be a useful adjuvant treatment to improve healing outcomes. However, a low level of physical activity is still observed in patients with venous leg ulcers and the reasons are multifactorial. A comprehensive understanding of the barriers and enablers to physical activity participation from different perspectives is crucial to develop workable interventions and achieve desired healing outcomes. Inclusion criteria: The review will consider qualitative studies that focus on evidence concerning the barriers and enablers influencing physical activity level in adults diagnosed with venous leg ulcers in all settings. Methods: Relevant studies will be searched in MEDLINE, CINAHL Plus, PsycINFO, and Emcare databases. Only studies published in English will be considered, with no date limits. Two independent reviewers will perform title and abstract screening and the full text of potential eligible studies will be retrieved and assessed against the inclusion criteria. All eligible studies will be appraised for methodological quality. Qualitative data will be extracted manually by two independent reviewers. A meta-aggregation approach will be used to pool and categorize findings from the included studies. The ConQual approach will be used to grade the final synthesized findings to determine confidence in the analysis findings. Systematic review registration number: PROSPERO CRD42021238579