scholarly journals Supervised Exercise Therapy using Mobile Health Technology in Patients with Peripheral Arterial Disease: Randomized Controlled Pilot Trial. (Preprint)

2020 ◽  
Author(s):  
Katrin Paldán ◽  
Martin Steinmetz ◽  
Jan Simanovski ◽  
Christos Rammos ◽  
Greta Ullrich ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Usual Care ◽  
Outcome Measure ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Supervised Exercise ◽  
Relevant Outcome Measure ◽  
Peripheral Arterial ◽  
Relevant Outcome

BACKGROUND Mobile interventions are intended to digitally nurse complex health care needs in chronic diseases, but they are mainly targeted at general health improvement and neglect disease-specific requirements. Therefore, we designed TrackPAD, a smartphone app to support supervised exercise training (SET) in patients with peripheral arterial disease (PAD). OBJECTIVE The aim of the present pilot study was to evaluate suitability, feasibility, and the impact on a prognosis relevant outcome measure for patients with PAD, the 6-minutes walking test, by using TrackPAD. METHODS Twenty-nine participants with symptomatic PAD were randomized. The study group (n=19) received usual care with additional use of TrackPAD. The control group (n=20) only received usual care. RESULTS The study group improved their 6-minutes walking distance, while the control group decreased their mean distance after 3 months of follow-up (83±72.2 vs. -38.8±53.7 m; p<0.01). The PAD-related quality of life improved significantly in terms of ‘symptom perception’ and ‘limitations in physical functioning’. Users’ feed-back showed increased motivation and a changed attitude to perform SET, while raising the educational background. CONCLUSIONS Besides the rating as a valued support tool by the user group, the mobile intervention TrackPAD was linked to an improvement in prognosis relevant outcome measure combined with an enhanced disease coping. CLINICALTRIAL International Registered Report Identifier (IRRID): DERR1-10.2196/13651

Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease

Vascular ◽  
2020 ◽  
pp. 170853812094724
Author(s):  
Ufuk Turan Kursat Korkmaz ◽  
Ahmet Yuksel ◽  
Ayhan Cetinkaya ◽  
Yusuf Velioglu ◽  
Erhan Renan Ucaroglu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Laboratory Data ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Total Thiol ◽  
Peripheral Arterial ◽  
Study Participants

Objective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case–control study. Participants’ baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group ( p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group ( p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.

scholarly journals Susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease

2009 ◽  
Vol 32 (5) ◽  
pp. 345 ◽  
Author(s):  
Katarzyna Skórkowska-Telichowska ◽  
Rajmund Adamiec ◽  
Dominika Tuchendler ◽  
Kazimierz Gąsiorowski
Keyword(s):  
Peripheral Arterial Disease ◽  
Fetal Calf Serum ◽  
Culture Media ◽  
Venous Blood ◽  
Calf Serum ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Low Culture ◽  
Peripheral Arterial

Purpose. To determine, in vitro, the susceptibility to apoptosis of lymphocytes from patients with peripheral arterial disease (PAD) in the presence of a low culture medium serum concentration, and to evaluate the correlation of the degree of apoptosis and the serum lipid levels. Methods. Lymphocytes were isolated from the venous blood of PAD patients with lower limb ischemia secondary to obliterative atherosclerosis of Fountain stage IIb. None of the patients had received hypo-lipemic therapy. The lymphocytes were incubated for 48 hr in media containing reduced concentrations of fetal calf serum. The study group consisted of 10 patients (7 men and 3 women), with a mean age of 67.0 ± 4.0 yr. The control group consisted of ten healthy volunteers, of the same mean age and sex proportion as the study group. Results. The percentage of non-apoptotic lymphocytes was lower (by 17%) and the percentage of late apoptotic lymphocytes was higher (by 33%) in the PAD patients than in the healthy donors when comparing the slopes of regression lines describing the relation between frequency of apoptotic lymphocytes in culture media containing reduced concentration of fetal calf serum The percentage of late apoptotic lymphocytes was correlated with the levels of total cholesterol (rs=0.93; P < 0.01) and LDL cholesterol (rs=0.80; P < 0.01) , and negatively correlated with the level of triglycerides (rs=-0.71; P < 0.05). Conclusion. The results of this study of lymphocyte apoptosis are important in understanding of the disease pathogenesis and should be taken into account in elaboration of treatment strategies.

scholarly journals Feasibility and Clinical Relevance of a Mobile Intervention Using TrackPAD to Support Supervised Exercise Therapy in Patients With Peripheral Arterial Disease: Study Protocol for a Randomized Controlled Pilot Trial (Preprint)

2019 ◽  
Author(s):  
Katrin Paldán ◽  
Jan Simanovski ◽  
Greta Ullrich ◽  
Martin Steinmetz ◽  
Christos Rammos ◽  
...  
Keyword(s):  
Arterial Disease ◽  
Walking Distance ◽  
Control Group ◽  
Study Group ◽  
Walk Test ◽  
Patient Centered ◽  
Supervised Exercise ◽  
Mobile Intervention ◽  
Peripheral Arterial

BACKGROUND Peripheral arterial disease (PAD) is a common and severe disease with a highly increased cardiovascular morbidity and mortality. Through the circulatory disorder and the linked undersupply of oxygen carriers in the lower limbs, the ongoing decrease of the pain-free walking distance occurs with a significant reduction in patients’ quality of life. Studies including activity monitoring for patients with PAD are rare and digital support to increase activity via mobile health technologies is mainly targeted at patients with cardiovascular disease in general. The special requirement of patients with PAD is the need to reach a certain pain level to improve the pain-free walking distance. Unfortunately, both poor adherence and availability of institutional resources are major problems in patient-centered care. OBJECTIVE The objective of this trackPAD pilot study is to evaluate the feasibility of a mobile phone–based self tracking app to promote physical activity and supervised exercise therapy (SET) in particular. We also aim for a subsequent patient centered adjustment of the app prototype based on the results of the app evaluation and process evaluation. METHODS This study was designed as a closed user group trial, with assessors blinded, and parallel group study with face-to-face components for assessment with a follow-up of 3 months. Patients with symptomatic PAD (Fontaine stage IIa or IIb) and possession of a mobile phone were eligible. Eligible participants were randomly assigned into study and control group, stratified by their distance covered in the 6-min walk test, using the software TENALEA. Participants randomized to the study group received usual care and the mobile intervention (trackPAD) for the follow-up period of 3 months, whereas participants randomized to the control group received only usual care. TrackPAD records the frequency and duration of training sessions and pain level using manual user input. Clinical outcome data were collected at the baseline and after 3 months via validated tools (6-min walk test, ankle-brachial index, and duplex ultrasound at the lower arteries) and self-reported quality of life. Usability and quality of the app was determined using the user version of the Mobile Application Rating Scale. RESULTS The study enrolled 45 participants with symptomatic PAD (44% male). Of these participants, 21 (47%) were randomized to the study group and 24 (53%) were randomized to the control group. The distance walked in the 6-min walk test was comparable in both groups at baseline (study group: mean 368.1m [SD 77.6] vs control group: mean 394.6m [SD 100.6]). CONCLUSIONS This is the first trial to test a mobile intervention called trackPAD that was designed especially for patients with PAD. Its results will provide important insights in terms of feasibility, effectiveness, and patient preferences of an app-based mobile intervention supporting SET for the conservative treatment of PAD. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13651

Cycling Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Patients with Peripheral Arterial Disease: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Tieh-Cheng Fu ◽  
Ming-Lu Lin ◽  
Chih-Chin Hsu ◽  
Shu-Chun Huang ◽  
Yu-Ting Lin ◽  
...  
Keyword(s):  
Exercise Training ◽  
Peripheral Arterial Disease ◽  
Aerobic Capacity ◽  
Short Form ◽  
Arterial Disease ◽  
Control Group ◽  
Mitochondrial Bioenergetics ◽  
Cycling Exercise ◽  
Complex Ii ◽  
Peripheral Arterial

AbstractExercise training influences the risk of vascular thrombosis in patients with peripheral arterial disease (PAD). Mitochondrial functionalities in platelets involve the cellular bioenergetics and thrombogenesis. This study aimed to elucidate the effect of cycling exercise training (CET) on platelet mitochondrial bioenergetics in PAD patients. Forty randomly selected patients with PAD engaged in general rehabilitation (GR) with CET (i.e., cycling exercise at ventilation threshold for 30 minute/day, 3 days/week) (GR + CET, n = 20) or to a control group that only received GR course (n = 20) for 12 weeks. Systemic aerobic capacity and platelet mitochondrial bioenergetics that included oxidative phosphorylation (OXPHOS) and electron transport system (ETS) were measured using automatic gas analysis and high-resolution respirometry, respectively. The experimental results demonstrated that GR + CET for 12 weeks significantly (1) elevated VO2peak and lowered VE-VCO2 slope, (2) raised resting ankle-brachial index and enhanced cardiac output response to exercise, (3) increased the distance in 6-minute walk test and raised the Short Form-36 physical/mental component scores, and (4) enhanced capacities of mitochondrial OXPHOS and ETS in platelets by activating FADH2 (complex II)-dependent pathway. Moreover, changes in VO2peak levels were positively associated with changes in platelet OXPHOS and ETS capacities. However, no significant changes in systemic aerobic capacity, platelet mitochondrial bioenergetics, and health-related quality of life (HRQoL) occurred following GR alone. Hence, we conclude that CET effectively increases the capacities of platelet mitochondrial bioenergetics by enhancing complex II activity in patients with PAD. Moreover, the exercise regimen also enhanced functional exercise capacity, consequently improving HRQoL in PAD patients.

scholarly journals Implementasi Metode Support Group Dalam Meningkatkan Persepsi Pasien Tentang Perawatan Diabetes Melitus di Kota Bandung

2020 ◽  
Vol 7 (1) ◽  
pp. 62-67
Author(s):  
Nandang Jamiat Nugraha ◽  
Rahmat Rahmat
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Arterial Disease ◽  
Support Group ◽  
Arterial Disease ◽  
Control Group ◽  
Post Test ◽  
Equivalent Control ◽  
Peripheral Arterial ◽  
Diabetes Melitus ◽  
Quasi Experiment

Diabetes Mellitus (DM) merupakan penyakit yang tidak dapat disembuhkan, namun dapat dikendalikan. Prevalensi penderita DM di Indonesia 6.9% dan di Jawa Barat sekitar 29,4% dari jumlah penduduknya. Sebagai mother of desease, penyakit DM memiliki komplikasi yang serius seperti retinopati diabetik, neuropati, amputasi, penyakit jantung, gagal jantung, stroke dan peripheral arterial disease. Kondisi tersebut menunjukkan perlunya keseriusan dalam penanganan penyakit DM. Diperlukan dukungan dari kader (sebagai bagian dari support group) bagi peserta prolanis DM. Tujuan penelitian ini adalah untuk mengetahui implementasi metoda support group dalam meningkatkan persepsi pasien tentang perawatan DM di Kota Bandung. Penelitian ini termasuk jenis penelitian kuantitatif dengan menggunakan rancangan quasi experiment dengan pretest and post test non equivalent control group. Hasil penelitian menunjukkan peningkatan persepsi pasien prolanis sebesar 3,08 dan peningkatannya dinyatakan sangat bermakna (p<0,01).  Edukasi yang dilakukan kader (support group) berpengaruh terhadap peningkatan persepsi pasien DM. Metode support group dengan memberdayakan kader dalam memberikan edukasi sangat bermanfaat dan dapat dijadikan kebijakan di pelayanan kesehatan masyarakat.

Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease

2021 ◽  
pp. 1-8
Author(s):  
Susan Matthews ◽  
Martin Fox ◽  
Sarah Coy ◽  
Jane Whittaker ◽  
Gail Brough ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Cardiac Rehabilitation ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Morbidity And Mortality ◽  
Supervised Exercise ◽  
Peripheral Arterial

Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

scholarly journals Heat therapy vs. supervised exercise therapy for peripheral arterial disease: a 12-wk randomized, controlled trial

2019 ◽  
Vol 316 (6) ◽  
pp. H1495-H1506 ◽  
Author(s):  
Ashley P. Akerman ◽  
Kate N. Thomas ◽  
Andre M. van Rij ◽  
E. Dianne Body ◽  
Mesfer Alfadhel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Water Immersion ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Hot Water ◽  
Walking Distance ◽  
Supervised Exercise ◽  
Heat Therapy ◽  
Peripheral Arterial

Peripheral arterial disease (PAD) is characterized by lower limb atherosclerosis impairing blood supply and causing walking-induced leg pain or claudication. Adherence to traditional exercise training programs is poor due to these symptoms despite exercise being a mainstay of conservative treatment. Heat therapy improves many cardiovascular health outcomes, so this study tested if this was a viable alternative cardiovascular therapy for PAD patients. Volunteers with PAD were randomized to 12 wk of heat ( n = 11; mean age 76 ± 8 yr, BMI 28.7 ± 3.5 kg/m2, 4 females) or exercise ( n = 11; 74 ± 10 yr, 28.5 ± 6.8 kg/m2, 3 females). Heat involved spa bathing at ∼39°C, 3–5 days/wk for ≤30 min, followed by ≤30 min of callisthenics. Exercise involved ≤90 min of supervised walking and gym-based exercise, 1–2 days/wk. Following the interventions, total walking distance during a 6-min walk test increased (from ∼350 m) by 41 m (95% CI: [13, 69], P = 0.006) regardless of group, and pain-free walking distance increased (from ∼170 m) by 43 m ([22, 63], P < 0.001). Systolic blood pressure was reduced more following heat (−7 mmHg, [−4, −10], P < 0.001) than following exercise (−3 mmHg, [0, −6], P = 0.078), and diastolic and mean arterial pressure decreased by 4 mmHg in both groups ( P = 0.002). There were no significant changes in blood volume, ankle-brachial index, or measures of vascular health. There were no differences in the improvement in functional or blood pressure outcomes between heat and exercise in individuals with PAD. NEW & NOTEWORTHY Heat therapy via hot-water immersion and supervised exercise both improved walking distance and resting blood pressure in peripheral arterial disease (PAD) patients over 12 wk. Adherence to heat therapy was excellent, and the heat intervention was well tolerated. The results of the current study indicate that heat therapy can improve functional ability and has potential as an effective cardiovascular conditioning tool for individuals with PAD. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/heat-therapy-vs-exercise-in-peripheral-arterial-disease/ .

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