Document Type : Research Paper

Authors

1 Department of Physical Education and Sport Science, Islamic Azad University Central Tehran Branch, Tehran, Iran

2 Clinical Biomechanics and Agronomy Research Center, Aja University of Medical Science, Tehran, Iran

3 Department of Physiology, Medical Faculty, Aja University of Medical Science, Tehran, Iran

Abstract

Purpose: Skin is the most important organ of the body and maintains its integrity is critical in good health. Severe skin damage is life-threatening and repairing restores its tissue integrity and delay in it endangers health. According to the importance of wound healing and the fact that not treated wounds may decrease quality of life, many studies have investigated the effect of some natural and chemical substance on the length and quality of wound healing to find out beneficial interventions that rapidly and economically treat it. This review aimed to describe the physiology of cutaneous wound healing and some negative and positive factor with a focus on exercise. Methods: An electronic search without any time limitation was performed on the PubMed, Google scholar and web of science databases to find published articles in English. The keywords were wound healing, exercise, and physiology. According to relation to subject, similarities, and differences 48 articles were selected and reviewed. Results: wound healing is a complicated physiology process that consists of four consecutive overlapping stages. Disruption in each stage disturbs wound healing. Many chemical and herbal compounds are used to speed up wound recovery due to their anti-inflammatory property. Exercise is one of the effective factors in wound healing and many studies evaluated effect of different protocol of exercise on it. The results of studies show that aerobic exercise due to its anti-inflammatory and antioxidative effect is a beneficial method in shortening the length of wound healing, especially in aged, fat, and diabetic individuals. Conclusion: Moderate intensity aerobic exercise as a complementary medicine is a good intervention in the treatment of impaired and chronic wounds.‎

Keywords

Adams, S. B., Sabesan, V. J., & Easley, M. E. (2006). Wound healing agents. Foot and ankle clinics, 11(4), 745-751.
Alah Gahi, F., Shiravi, A., & Hojati, V. (2016). Histomorphometric study effect of alcoholic extract of grape seed (Vitis Vinifera) on wound healing diabetic male Wistar rats. Journal of Cell & Tissue, 7(3), 293300.
Amatriain-Fernández, S., Gronwald, T., Murillo-Rodríguez, E., Imperatori, C., Solano, A. F., Latini, A., & Budde, H. (2020). Physical exercise potentials against viral diseases like COVID-19 in the elderly. Frontiers in medicine, 7, 379.
Bermudez, D. M., Herdrich, B. J., Xu, J., Lind, R., Beason, D. P., Mitchell, M. E., ... & Liechty, K. W. (2011). Impaired biomechanical properties of diabetic skin: implications in pathogenesis of diabetic wound complications. The American journal of pathology, 178(5), 2215-2223.
Bolton, L. (2019). Exercise and chronic wound healing. Wounds: a compendium of clinical research and practice, 31(2), 65-67.
Boucek, R. J. (1984). Factors affecting wound healing. Otolaryngologic Clinics of North America, 17(2), 243-264.
Christian, L.M., et al., (2006). Stress and wound healing. Neuroimmunomodulation,. 13(5-6): 337-346.
Ebrecht, M., Hextall, J., Kirtley, L. G., Taylor, A., Dyson, M., & Weinman, J. (2004). Perceived stress and cortisol levels predict speed of wound healing in healthy male adults. Psychoneuroendocrinology, 29(6), 798809.
Emery, C. F., Kiecolt-Glaser, J. K., Glaser, R., Malarkey, W. B., & Frid, D. J. (2005). Exercise accelerates wound healing among healthy older adults: a preliminary investigation. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(11), 1432-1436. Eraydin,‎ Ş.,‎ &‎ Avşar,‎ G.‎ (2018).‎ The‎ effect‎ of‎ foot‎ exercises‎ on‎ wound‎ healing in type 2 diabetic patients with a foot ulcer. Journal of Wound, Ostomy and Continence Nursing, 45(2), 123-130.
Flahr, D. (2010). The effect of nonweight-bearing exercise and protocol adherence on diabetic foot ulcer healing: a pilot study. Ostomy/wound management, 56(10), 40.
Gosain, A., & DiPietro, L. A. (2004). Aging and wound healing. World journal of surgery, 28(3), 321-326.
Gustirini, R., Pratama, R. N., & Maya, R. A. A. (2020, July). The Effectiveness of Kegel Exercise for the Acceleration of Perineum Wound Healing on Postpartum Women. In 1st International Conference on Science, Health, Economics, Education and Technology (ICoSHEET 2019) (pp. 400-402). Atlantis Press.
Heinen, M., Borm, G., van der Vleuten, C., Evers, A., Oostendorp, R., & van Achterberg, T. (2012). The Lively Legs self-management programme increased physical activity and reduced wound days in leg ulcer patients: Results from a randomized controlled trial. International journal of nursing studies, 49(2), 151-161.
Irmawati, A., Giffari, F. Z., & Oki, A. S. (2018). The effect of moderete exercise on VEGF (Vascular Endothrlial Growth Factor) Expression during tooth socket wound healing after tooth extraction. Journal of Postgraduate Medical Institute, 32(1), 19-23.
Javadi, S. M. R., Hashemi, M., Mohammadi, Y., MamMohammadi, A., Sharifi, A., & Makarchian, H. R. (2018). Synergistic effect of honey and
Nigella sativa on wound healing in rats. Acta cirurgica brasileira, 33, 518-523.
 
 
Karimi, Z., Behnammoghadam, M., Rafiei, H., Abdi, N., Zoladl, M., Talebianpoor, M. S., ... & Khastavaneh, M. (2019). Impact of olive oil and honey on healing of diabetic foot: a randomized controlled trial. Clinical, Cosmetic and Investigational Dermatology, 12, 347.
Keylock, K. T., & Young, H. (2010). Delayed Wound Healing: Can Exercise Accelerate it?. International Journal of Exercise Science, 3(3), 2.
Keylock, K. T., Vieira, V. J., Wallig, M. A., DiPietro, L. A., Schrementi, M., & Woods, J. A. (2008). Exercise accelerates cutaneous wound healing and decreases wound inflammation in aged mice. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 294(1), R179-R184.
LeSaint, M., Balaji, S., Bhattacharya, S. B., Moles, C. M., Kidd, M., Dhamija, Y., ... & Keswani, S. G. (2014). Adenoviral Mediated Gene Transfer of Insulin-like Growth Factor-1 (IGF-1) Enhances Wound Healing and Induces Angiogenesis. Journal of Surgical Research, 186(2), 653.
Martinotti, S., & Ranzato, E. (2018). Honey, wound repair and regenerative medicine. Journal of functional biomaterials, 9(2), 34.
Mathur, N., & Pedersen, B. K. (2008). Exercise as a mean to control lowgrade systemic inflammation. Mediators of inflammation, 2008.
Monte‐Alto‐Costa, A., Saguie, B., & Romana‐Souza, B. (2015). Moderate Exercise Does Not Reverse Adverse Effects Of Stress On Cutaneous Wound Healing. The FASEB Journal, 29, 876-1.
Nurkesh, A., Jaguparov, A., Jimi, S., & Saparov, A. (2020). Recent advances in the controlled release of growth factors and cytokines for improving cutaneous wound healing. Frontiers in Cell and Developmental
Biology, 8, 638.
O'Brien, J., Finlayson, K., Kerr, G., & Edwards, H. (2017). Evaluating the effectiveness of a self‐management exercise intervention on wound healing, functional ability and health‐related quality of life outcomes in adults with venous leg ulcers: a randomised controlled trial. International Wound Journal, 14(1), 130-137.
Oki, A. S., & Amalia, N. (2020). Wound healing acceleration in inflammation phase of post-tooth extraction after aerobic and anaerobic exercise. Science & Sports, 35(3), 168-e1.
Pence, B. D. (2012). Effect of treadmill exercise on cutaneous wound healing in obese mice. University of Illinois at Urbana-Champaign.
Pence, B. D., DiPietro, L. A., & Woods, J. A. (2012). Exercise speeds cutaneous wound healing in high-fat diet-induced obese mice. Medicine and science in sports and exercise, 44(10), 1846-1854.
Pence, B. D., & Woods, J. A. (2014). Exercise, obesity, and cutaneous wound healing: evidence from rodent and human studies. Advances in wound care, 3(1), 71-79.
Riahi, S., Imani, H., Torkamaan, G., Mofid, M., Ghoshouni, H., & Khoushbaten, A. (2008). Effect of topical application of honey on skin wound healing with full thickness in male rats.
Riahi, S., Mofid, M., Imani, H., Asgari, A. R., Ghosghouni, H., Habibi, M. R., & Khosh Baten, A. (2006). Histological study of topical application of sodium phenytoin 1% ointment on open skin healing in male rats. Anatomical Sciences Journal, 3(4), 269-279.
Riahi, S., Mohammadi, M. T., & Sobhani, V. (2014). Role of oxygen and nitrogen free radicals in diabetes-induced atherosclerosis, and effects of exercise on it. Physiology and Pharmacology, 18(1), 1-15.
Roy, S., Khanna, S., & Sen, C. K. (2008). Redox regulation of the VEGF signaling path and tissue vascularization: Hydrogen peroxide, the common link between physical exercise and cutaneous wound healing. Free radical biology and medicine, 44(2), 180-192.
Roy, S., Khanna, S., Nallu, K., Hunt, T. K., & Sen, C. K. (2006). Dermal wound healing is subject to redox control. Molecular therapy, 13(1), 211220.
Saghazadeh, S., Rinoldi, C., Schot, M., Kashaf, S. S., Sharifi, F., Jalilian, E., ... & Khademhosseini, A. (2018). Drug delivery systems and materials for wound healing applications. Advanced drug delivery reviews, 127, 138-166.
Saguie, B. O., Romana‐Souza, B., Martins, R. L., & Monte‐Alto‐Costa, A. (2017). Exercise prior to, but not concomitant with, stress reverses stressinduced delayed skin wound healing. Wound Repair and
Regeneration, 25(4), 641-651.
Sallehuddin, N., Nordin, A., Bt Hj Idrus, R., & Fauzi, M. B. (2020). Nigella sativa and its active compound, thymoquinone, accelerate wound healing in an in vivo animal model: a comprehensive review. International journal of environmental research and public health, 17(11), 4160.
Sen, C. K., Khanna, S., Babior, B. M., Hunt, T. K., Ellison, E. C., & Roy, S. (2002). Oxidant-induced vascular endothelial growth factor expression in human keratinocytes and cutaneous wound healing. Journal of Biological Chemistry, 277(36), 33284-33290.
Shi, C., Wang, C., Liu, H., Li, Q., Li, R., Zhang, Y., ... & Wang, J. (2020). Selection of appropriate wound dressing for various wounds. Frontiers in bioengineering and biotechnology, 8, 182.
 
Szczodry, M., Zhang, J., Lim, C., Davitt, H. L., Yeager, T., Fu, F. H., & Wang, J. H. C. (2009). Treadmill running exercise results in the presence of numerous myofibroblasts in mouse patellar tendons. Journal of Orthopaedic Research, 27(10), 1373-1378.
Tew, G. A., Michaels, J., Crank, H., Middleton, G., Gumber, A., & Klonizakis, M. (2015). Supervised exercise training as an adjunctive therapy for venous leg ulcers: study protocol for a randomised controlled trial. Trials, 16(1), 1-10.
Tottoli, E. M., Dorati, R., Genta, I., Chiesa, E., Pisani, S., & Conti, B. (2020). Skin wound healing process and new emerging technologies for skin wound care and regeneration. Pharmaceutics, 12(8), 735.
Whitney, J. D., & Parkman, S. (2004). The effect of early postoperative physical activity on tissue oxygen and wound healing. Biological Research for Nursing, 6(2), 79-89.
Wolfe, A. (2013). Exercise Intensity and Wound Healing in Diabetic Mice.
Wong, W., Crane, E. D., Kuo, Y., Kim, A., & Crane, J. D. (2019). The exercise cytokine interleukin-15 rescues slow wound healing in aged mice. Journal of Biological Chemistry, 294(52), 20024-20038.
Zhang, X., Shu, W., Yu, Q., Qu, W., Wang, Y., & Li, R. (2020). Functional biomaterials for treatment of chronic wound. Frontiers in Bioengineering and Biotechnology, 8, 516.
Zhou, W., Liu, G. H., Yang, S. H., Mi, B. B., & Ye, S. N. (2016). Lowintensity treadmill exercise promotes rat dorsal wound healing. Journal of Huazhong University of Science and Technology [Medical Sciences], 36(1), 121-126.
Zogaib, F. G., & Monte-Alto-Costa, A. (2011). Moderate intensity physical training accelerates healing of full-thickness wounds in mice. Brazilian Journal of Medical and Biological Research, 44, 1025-1035.