scholarly journals Supervised Exercise Training for Intermittent Claudication: Lasting Benefit at Three Years

2007 ◽  
Vol 34 (3) ◽  
pp. 322-326 ◽  
Author(s):  
D.A. Ratliff ◽  
M. Puttick ◽  
G. Libertiny ◽  
R.C.J. Hicks ◽  
L.E. Earby ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Supervised Exercise

scholarly journals Supervised Exercise Training for Intermittent Claudication: Lasting Benefit at Three Years

2007 ◽  
Vol 46 (3) ◽  
pp. 611
Author(s):  
D.A. Ratliff ◽  
M. Puttick ◽  
G. Libertiny ◽  
R.C.J. Hicks ◽  
L.E. Earby ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Supervised Exercise

Long-term effects of supervised exercise training on walking capacity and quality of life in patients with intermittent claudication

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 250-256 ◽  
Author(s):  
Keo ◽  
Grob ◽  
Guggisberg ◽  
Widmer ◽  
Baumgartner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Exercise Training ◽  
Intermittent Claudication ◽  
Long Term Effects ◽  
Supervised Exercise ◽  
Exercise Training Program ◽  
Walking Capacity

Supervised exercise training has been shown to improve walking capacity in several studies of patients with intermittent claudication. However, data on long-term outcome are quite limited. The aim of this prospective study was to evaluate long-term effects of supervised exercise training on walking capacity and quality of life in patients with intermittent claudication. Patients and methods: Sixty-seven consecutive patients with intermittent claudication who completed a supervised 12-week exercise training program were asked for follow up evaluation 39 ± 20 months after program completion. Pain-free walking distance (PWD) and maximum walking distances (MWD) were assessed by treadmill test and several questionnaires. Results: Forty (60%) patients agreed to participate, 22 (33%) refused participation, and 5 (7%) died during follow-up. PWD and MWD significantly improved at completion of 12-weeks supervised exercise training as compared to baseline (PWD 114 ± 100 vs. 235 ± 248, p = 0.002; MWD 297 ± 273 vs. 474 ± 359, p = 0.001). Improvement of PWD and MWD could be maintained at follow up (197 ± 254, p = 0.014; 390 ± 324, p = 0.035, respectively) with non-smokers showing significantly better sustained PWD and MWD improvement as compared to baseline. Overall, walking capacity correlated with functional status of quality of life. Conclusions: Major findings of this investigation were that improvement in walking capacity is sustained after completion of supervised exercise training program with best results in patients who quitted or never smoked. Improved walking capacity is associated with increased functional status of quality of life.

Local Versus Systemic Mechanisms Underlying Supervised Exercise Training for Intermittent Claudication

2008 ◽  
Vol 42 (4) ◽  
pp. 314-320 ◽  
Author(s):  
Andrew HR. Stewart ◽  
Frank CT. Smith ◽  
Roger N. Baird ◽  
Peter M. Lamont
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Supervised Exercise

scholarly journals Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners

2020 ◽  
Vol 6 (1) ◽  
pp. e000897
Author(s):  
Amy E Harwood ◽  
Sean Pymer ◽  
Lee Ingle ◽  
Patrick Doherty ◽  
Ian C Chetter ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Mode Of Delivery ◽  
Lower Limbs ◽  
Walking Distance ◽  
Walking Ability ◽  
Aerobic Activity ◽  
Supervised Exercise ◽  
Home Based ◽  
Exercise Programmes

Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with the strongest evidence and is recommended in several national and international guidelines. Alternate forms of exercise such as upper- or lower-body cycling may be used, if required by certain patients, although there is less evidence for these types of programmes. The evidence for progressive resistance training is growing and patients can also engage in strength-based training alongside a walking programme. For those unable to attend a supervised class (strongest evidence), home-based or ‘self-facilitated’ exercise programmes are known to improve walking distance when compared to simple advice. All exercise programmes, independent of the mode of delivery, should be progressive and individually prescribed where possible, considering disease severity, comorbidities and initial exercise capacity. All patients should aim to accumulate at least 30 min of aerobic activity, at least three times a week, for at least 3 months, ideally in the form of walking exercise to near-maximal claudication pain.

Abstract 19720: Jay D. Coffman Early Career Investigator Award: Comparative Efficacy of Initial Endovascular Revascularization vs. Supervised Exercise Training in Patients With Intermittent Claudication: A Meta-analysis of Randomized Controlled Trials

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ambarish Pandey ◽  
Subhash Banerjee ◽  
Christian Ngo ◽  
Purav Mody ◽  
Steven Marso ◽  
...  
Keyword(s):  
Exercise Training ◽  
Randomized Controlled Trials ◽  
Intermittent Claudication ◽  
Meta Analysis ◽  
Walking Distance ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Supervised Exercise ◽  
Endovascular Revascularization

Introduction: Current guidelines recommend supervised exercise training (SET) as the initial treatment modality for patients with intermittent claudication (IC), in addition to optimal medical therapy. The role of endovascular revascularization (ER) as a primary treatment option has been controversial. We performed a meta-analysis to compare the efficacy of initial ER vs. initial SET in patients with IC using data from randomized controlled trials. Methods: The primary outcome was treadmill-measured maximum walking distance (MWD) at the end of follow-up. Secondary outcomes included resting ankle brachial index (ABI) and treadmill-measured ischemic claudication distance (ICD) on follow-up. Risk of adverse limb events (revascularization, amputations) was also compared between the two groups. Random effects models were used for all analyses. Results: We included 1,145 patients from nine trials with a mean follow up duration of 13.7 months (42% aortoiliac lesions; 35% stent use; mean baseline ABI 0.64 vs. 0.67 for ER vs. SET). Follow-up MWD was not significantly different between patients undergoing ER vs. SET [Weighted mean difference (WMD) (95% CI): 19.1 m (-79.6 to 117.8 m); publication bias p=0.86]. Metaregression did not identify significant differences based on stent use or presence of aortoiliac disease. ICD was also similar between the two groups [WMD (95% CI): 36.1 m (-99.4 to 171.5 m)]. In contrast, patients undergoing ER had higher resting ABI on follow-up [WMD (95% CI): 0.14 (0.11 to 0.17), p<0.0001]. Adverse limb event rates were similar [5.4% vs. 8.2%, p=0.21]. Conclusion: Compared with initial SET, initial ER significantly improves resting ABI values. Although longer walking distance and lower rates of adverse limb events also appeared favorable for ER, these differences were not statistically significant in these intermediate term studies. Longer-term studies and those incorporating contemporary revascularization techniques are necessary.

scholarly journals Short and medium term functional capacity after single cycle of controlled physical training in subjects with claudication

2016 ◽  
Vol 70 (2) ◽  
Author(s):  
Roberto Carlon ◽  
Armando Olivieri ◽  
Luca Benacchio ◽  
Mario Zanchetta
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Physical Training ◽  
Pain Threshold ◽  
Medium Term ◽  
Supervised Exercise ◽  
Walking Capacity ◽  
Treadmill Testing ◽  
Artery Disease

BACKGROUND. Previous studies have shown the positive effect of exercise rehabilitation in patients with claudication, but uncertainties remain surrounding the optimal exercise program strategy and the persistence of the benefits over time. The purpose of the present study has been to prospectively assess the feasibility of short-course intensive supervised exercise training beyond pain threshold and to verify the maintenance of walking capacity during a medium term follow-up. METHODS. Ninety patients with intermittent claudication due to peripheral artery disease were enrolled in a supervised intensive exercise training. Seventy six of them (67 ± 7 years, 64 male and 12 female, 48 with bilateral claudication) performed a graded treadmill testing at baseline and after 3 months. Sixty patients completed also a specific questionnaire (Walking Impairement Questionnarie). After a mean follow-up of 2.6 years, fifty six patients repeated treadmill testing and 24 patients repeated the questionnaire. RESULTS. After training, the patients showed a 91% and 53% increase in the initial and absolute claudication distance time, respectively (p=0.0000). At follow-up there was no change in the initial claudication distance time, whereas absolute claudication distance time was reduced by only 13% (p=0.0001). All items of the questionnaire showed a statistically significant improvement after training (from 30 to 71%) and remained unchanged at follow-up. Sixty seven percent of the patients were considered responder, 15% partial responder and 18% no-responder to exercise training, whereas at follow- up these percentages were 55%, 13% and 32%, respectively. These results after training and at follow-up were independent from age, sex, smoke, hypertension, coronary artery disease and diabetes. CONCLUSIONS. Our findings confirm that a short supervised exercise therapy in the form of walking out over pain threshold is effective in maximizing the walking time of the majority of patients with intermittent claudication, independently of demographic data and their associated cardiac risk factors or comorbidities. After a mean follow-up of 2.6 years there was only a minor reduction of absolute claudication distance time and no modification of initial claudication distance time and questionnaire’s score, despite the fact that none of these patients were contacted by the rehabilitation centre after their physical training period.

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