Availability of Supervised Exercise Programs and the Role of Structured Home-based Exercise in Peripheral Arterial Disease

Makris, Gregory C.; Lattimer, Christopher; Lavida, A.; Geroulakos, George

doi:10.1016/j.ejvs.2012.09.009

Cited by 110 publications

(97 citation statements)

References 25 publications

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“…Makris et al surveyed practitioners regarding the availability of supervised exercise programs for PAD patients. 42 The majority of respondents were practicing in Europe. Only 30% of respondents reported having access to a supervised program for their patients.…”

Section: Health Promotion and Adherencementioning

confidence: 99%

Physical Activity and Exercise for Secondary Prevention among Patients with Cardiovascular Disease

Darden

Richardson²,

Jackson

2013

Curr Cardiovasc Risk Rep

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Most adults do not achieve the recommended levels of physical activity, including patients with cardiovascular disease (CVD). Furthermore, healthcare providers often do not understand the benefits of physical activity in CVD patients, rather over emphasizing the potential risks related to activity. Recent studies suggest reductions in cardiovascular events including mortality with concomitant improvements in quality of life for many vascular conditions. However gaps in our current knowledge base remain. Recent research on physical activity including use of novel internet based interventions are developing areas of interest have moved to reduce such knowledge gaps.

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Section: Health Promotion and Adherencementioning

confidence: 99%

Physical Activity and Exercise for Secondary Prevention among Patients with Cardiovascular Disease

Darden

Richardson²,

Jackson

2013

Curr Cardiovasc Risk Rep

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“…2,14 Research suggests self-directed walking is associated with significantly less functional decline when performed at least three times/week compared with only one-two times/week. 2,15 Supervised exercise, at sufficient intensity has been shown to increase blood flow to dorsiflexors. 16,17 However, patients with co-morbidities and ischemic walking pain are often unable or unwilling to participate in regular exercise.…”

Section: Introductionmentioning

confidence: 99%

Functional electrical stimulation improves quality of life by reducing intermittent claudication

Embrey

Alon

Brandsma

et al. 2017

International Journal of Cardiology

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Objective To determine if Functional Electrical Stimulation (FES) would improve ischemic pain, walking distance, and quality of life of patients with intermittent claudication. Design Single blind, randomized block, two factorial design. Patients Patients diagnosed with Peripheral Artery Disease (PAD) and intermittent claudication (IC). Ankle Brachial Index ranged 0.4–0.9 on at least one leg. Patients were randomly assigned to experimental (FES+Walk, N=13) or control (WALK, N=14) groups. Intervention Experimental group patients received FES to the dorsiflexor and plantarflexor muscles while walking for one hour/day, six days/week for eight weeks. Control group patients received similar intervention without FES. A Follow-up period of both groups lasted eight weeks. Outcome Measures Outcome measures were taken at baseline (T0), after intervention (T1), and after follow-up (T2). Primary measures included Perceived Pain Intensity (PPI), Six Minute Walk (6MW), and Peripheral Arterial Disease Quality of Life (PADQOL). Secondary measures included Intermittent Claudication Questionnaire (ICQ) and Timed Up and Go (TUG). Results Group by time interactions in PPI were significant (P<.001) with differences of 27.9 points at T1 and 36.9 points at T2 favoring the FES+Walk group. Groups difference in Symptoms and Limitations in Physical Function of the PADQOL reached significance (T1=8.9, and T2=8.3 improvements; P=.007). ICQ was significant (T1=9.3 and T2=13.1 improvements; P=.003). Improvement in 6MW and TUG tests were similar between groups. Conclusions and Relevance Walking with FES markedly reduced ischemic pain and enhanced QOL compared to just walking. FES while walking may offer an effective treatment option for the elderly with PAD and Intermittent Claudication.

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“…Other secondary outcome measures using objective assessment will include:Ambulatory ability and lower body functioning: This will be assessed using the 6MWT, and the Short Physical Performance Battery (SPPB) which have previously been used as outcome measures in PAD intervention trials [36, 37]. The 6MWT assesses maximal cardiorespiratory fitness and correlates strongly with physical activity levels among people with PAD, and may therefore reflect walking capacity in everyday life [63].…”

Section: Methodsmentioning

confidence: 99%

“…However, an international survey found only 30 % of vascular surgeons had access to supervised exercise programmes for patients with PAD, and of those who did have access, many referred less than half their patients [37]. Patient travel to facility-based supervised exercise sessions is burdensome, and drop-out rates are often high [38–40].…”

Section: Introductionmentioning

confidence: 99%

“…Patient travel to facility-based supervised exercise sessions is burdensome, and drop-out rates are often high [38–40]. Lack of patient and physician awareness of the role of supervised exercise, and patient barriers of transportation and time contribute to this being an underused treatment [37, 41, 42]. For those surgeons who do not have access to refer to supervised exercise programmes, the usual option is to give brief advice to do walking [37].…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial

et al. 2016

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BackgroundPhysical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD.MethodsThis is a multi-center randomised controlled trial in four cities across Australia. Participants (N = 200) will be recruited from specialist vascular clinics, general practitioners and research databases and randomised to either the control or intervention group. Both groups will receive usual medical care, a written PAD management information sheet including advice to walk, and four individualised contacts from a protocol-trained allied health professional over 3 months (weeks 1, 2, 6, 12). The control group will receive four 15-min telephone calls with general discussion about PAD symptoms and health and wellbeing. The intervention group will receive behavioral counselling via two 1-h face-to-face sessions and two 15-min telephone calls. The counselling is based on the 5A framework and will promote interval walking for 3 × 40 min/week. Assessments will be conducted at baseline, and 4, 12 and 24 months by staff blinded to participant allocation. Objectively assessed outcomes include physical activity (primary), sedentary behavior, lower limb body function, walking capacity, cardiorespiratory fitness, event-based claudication index, vascular interventions, clinical events, cardiovascular function, circulating markers, and anthropometric measures. Self-reported outcomes include physical activity and sedentary behavior, walking ability, pain severity, and health-related quality of life. Data will be analysed using an intention-to-treat approach. An economic evaluation will assess whether embedding the intervention into routine care would likely be value for money. A cost-effectiveness analysis will estimate change in cost per change in activity indicators due to the intervention, and a cost-utility analysis will assess change in cost per quality-adjusted life year. A full uncertainty analysis will be undertaken, including a value of information analysis, to evaluate the economic case for further research.DiscussionThis trial will evaluate the efficacy and cost-effectiveness of a brief behavioral counselling intervention for a common cardiovascular disease with significant burden.Trial registrationACTRN 12614000592640 Australian New Zealand Clinical Trials Registry. Registration Date 4 June 2014.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3801-7) contains supplementary material, which is available to authorized users.

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Availability of Supervised Exercise Programs and the Role of Structured Home-based Exercise in Peripheral Arterial Disease

Abstract: SEPs remain an underutilized tool despite recommendations. Structured HEPs may be effective and can be useful alternatives when SEPs are not available. Further research is warranted to establish cost-effectiveness.

Cited by 110 publications

References 25 publications

Physical Activity and Exercise for Secondary Prevention among Patients with Cardiovascular Disease

Physical Activity and Exercise for Secondary Prevention among Patients with Cardiovascular Disease

Functional electrical stimulation improves quality of life by reducing intermittent claudication

Efficacy of brief behavioral counselling by allied health professionals to promote physical activity in people with peripheral arterial disease (BIPP): study protocol for a multi-center randomized controlled trial

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