Claudicating patients with peripheral artery disease have meaningful improvement in walking speed after supervised exercise therapy

Rahman, Hafizur; Pipinos, Iraklis I.; Johanning, Jason M.; Casale, George P.; Williams, Mark A.; Thompson, Jonathan R.; O'Neill-Castro, Yohanis; Myers, Sara A.

doi:10.1016/j.jvs.2021.04.069

Cited by 15 publications

(3 citation statements)

References 37 publications

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“… 39 Similarly, the improvements in the habitual gait speed rapidly observed after the first month of the SET program (from 1.10 to 1.20 m·s –1 ) are larger than the MCID for substantial improvements observed after the SET program (+0.08 m·s –1 ). 40 Finally, the improvements in the SPPB total score after the first month of the SET program (from 10.3 to 11.2 points) are similar to the MCID for small to substantial changes observed in community-dwelling older adults. 41 Taken together, the results of the present investigation suggest that functional exercises should be implemented in training programs in patients with PAD with regard to optimizing functional performance and inducing rapid changes in these patients.…”

Section: Discussionmentioning

confidence: 52%

Time-course evolution of functional performance during a 3-month supervised exercise training program in patients with symptomatic peripheral artery disease

Lanzi,

Pousaz,

Calanca

et al. 2023

Vasc Med

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Introduction: Functional performance is impaired in patients with peripheral artery disease (PAD). The effects of a supervised exercise training (SET) program on functional performance have yet to be clearly determined. The aim was to investigate the time-course evolution of functional performance during a 3-month SET program. Methods: Patients with chronic symptomatic PAD participating in a 3-month SET program were investigated. Six-minute walking distance (6MWD), the stair climbing test (SCT), and the Short Physical Performance Battery (SPPB) were assessed before SET, after the first and second months of SET, and following the SET program. The ankle– and toe–brachial indices were measured before and after the SET program. Results: Ninety patients with PAD (age 65.4 ± 10.2 years) were analyzed. The 6MWD significantly improved after the first (+7%, p ⩽ 0.001) and second months (+13%, p ⩽ 0.001) and following SET (+14%, p ⩽ 0.001) compared to before the SET program. The 6MWD significantly improved after the 2nd month (+6%, p ⩽ 0.001) and following SET (+7%, p ⩽ 0.001) compared to after the first month of the SET program. The SPPB score and SCT performance significantly improved after the first (SPPB score: +9%, p ⩽ 0.001; SCT: +17%, p ⩽ 0.001) and second months (SPPB score: +11%, p ⩽ 0.001; SCT: +24%, p ⩽ 0.001) and following SET (SPPB score: +12%, p ⩽ 0.001; SCT: +25%, p ⩽ 0.001) compared to before the SET program. No significant differences were observed following SET compared to the second month of the SET program. Vascular parameters did not change significantly. Conclusions: A 3-month SET program improves several components of functional performance, and adaptations mainly occur during the 1st and 2nd months of the SET program.

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Section: Discussionmentioning

confidence: 52%

Time-course evolution of functional performance during a 3-month supervised exercise training program in patients with symptomatic peripheral artery disease

Lanzi,

Pousaz,

Calanca

et al. 2023

Vasc Med

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“…The increase in MVPA of 11 minutes each day was accomplished by walking at faster cadence in the community-based setting, which supports a recent study that found increases in walking speed of 0.05 and 0.15 m/sec over 10 meters in the laboratory corresponded to small and substantial MCID increases in patients with PAD. 41 Similar to the time spent in MVPA, an increase of 1211 total daily steps was associated with a large anchor-based MCID increase in HRQoL. This may be a more feasible goal for patients who are more severely diseased and functionally limited, as the total steps can be completed at a lower cadence (i.e., intensity) of walking.…”

Section: Discussionmentioning

confidence: 85%

Minimal clinically important differences in daily physical activity outcomes following supervised and home-based exercise in peripheral artery disease

et al. 2022

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Introduction: We estimated minimal clinically important differences (MCID) for small, moderate, and large changes in daily step counts and time spent in moderate-to-vigorous physical activity (MVPA) following both supervised and home-based exercise programs in symptomatic patients with peripheral artery disease (PAD). Methods: Patients were randomized to either 12 weeks of a supervised exercise program ( n = 60), a home-based exercise program ( n = 60), or an attention-control group ( n = 60). Results: Using the anchor-based method to determine MCID, the MCID value for a large change in health-related quality of life (HRQoL) was an increase of 1211 total daily steps and an increase in 11 minutes in the time spent in MVPA following 12 weeks of exercise intervention. Using the distribution-based method, the MCID values for small, moderate, and large changes in total daily steps in the home-based exercise group were 558, 1396, and 2233 steps/d, respectively, and the corresponding changes in the time spent in MVPA were 6, 15, and 23 minutes. Similar distribution-based MCID scores were noted for the supervised exercise group. Conclusion: Following 3 months of home-based and supervised exercise programs for patients with PAD and claudication, increases of 11 minutes in time spent in MVPA and 1211 total daily steps were associated with large anchor-based MCID increases in HRQoL. The clinical implication is that patients with PAD and claudication should be encouraged to increase daily steps, particularly by walking an additional 11 minutes each day in MVPA, which is associated with a large meaningful increase in HRQoL.

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“…Moreover, exercise therapy as the initial intervention for IC was endorsed, because it benefits the walking distance to the onset of claudication and maximum claudication pain, with some studies displaying clinical improvement in walking speed after 6 months of supervised exercise therapy. 9 , 13 …”

Section: Discussionmentioning

confidence: 99%

Nitinol overdose—rescue of acute limb ischemia caused by stenting of the common iliac, external iliac, common femoral, superficial femoral, and popliteal arteries in an actively smoking patient with claudication

Patel

Hamilton

Huntress

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Claudicating patients with peripheral artery disease have meaningful improvement in walking speed after supervised exercise therapy

Cited by 15 publications

References 37 publications

Time-course evolution of functional performance during a 3-month supervised exercise training program in patients with symptomatic peripheral artery disease

Time-course evolution of functional performance during a 3-month supervised exercise training program in patients with symptomatic peripheral artery disease

Minimal clinically important differences in daily physical activity outcomes following supervised and home-based exercise in peripheral artery disease

Nitinol overdose—rescue of acute limb ischemia caused by stenting of the common iliac, external iliac, common femoral, superficial femoral, and popliteal arteries in an actively smoking patient with claudication

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