Gender Differences in Outcomes Following a Pain-Free, Home-Based Exercise Program for Claudication

Manfredini, Roberto; Lamberti, Nicola; Manfredini, Fabio; Straudi, Sofía; Fabbian, Fabio; Rodríguez‐Borrego, María Aurora; Basaglia, Nino; Carmona‐Torres, Juan Manuel; Soto, Pablo

doi:10.1089/jwh.2018.7113

Cited by 25 publications

(22 citation statements)

References 53 publications

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“…Interestingly, when normalising the FAC variations for the number of RAGT sessions performed, women exhibited a significantly greater response to RAGT given an equal number of training sessions. This represents a relevant aspect, considering women's limited adherence to rehabilitation in several chronic diseases with respect to men, as previously reported [26][27][28][29][30][31]. Moreover, this finding supported the greater responsiveness of women to RAGT, leading to the hypothesis that they need fewer sessions to achieve the same gait function.…”

Section: Discussionsupporting

confidence: 78%

“…Rehabilitation is a critical issue for women, considering their lower response or adherence to rehabilitation for various chronic diseases [26][27][28][29][30][31]. After a stroke, sex was associated with lower post-stroke physical activity [32] and different improvements in physical function following home-based rehabilitation among home-dwelling patients [33].…”

Section: Introductionmentioning

confidence: 99%

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Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

et al. 2021

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Background and Objectives: Robot-assisted gait training (RAGT) could be a rehabilitation option for patients after experiencing a stroke. This study aims to determine the sex-related response to robot-assisted gait training in a cohort of subacute stroke patients considering mixed results previously reported. Materials and Methods: In this study, 236 participants (145 males, 91 females) were admitted to a rehabilitation facility after experiencing a stroke and performed RAGT within a multidisciplinary rehabilitation program. Functional Independence Measure (FIM) and Functional Ambulatory Category (FAC) were assessed at admission and discharge to determine sex-related outcomes. Results: At the baseline, no significant difference among sexes was observed. At the end of rehabilitation, both males and females exhibited significant improvements in FIM (71% of males and 80% of females reaching the MCID cut-off value) and FAC (∆score: men 1.9 ± 1.0; women 2.1 ± 1.1). A more remarkable improvement was observed in women of the whole population during the study, but statistical significance was not reached. When analysing the FAC variations with respect to the total number of RAGT sessions, a more significant improvement was observed in women than men (p = 0.025). Conclusion: In conclusion, among subacute stroke patients, benefits were observed following RAGT during a multidisciplinary rehabilitation program in both sexes. A greater significant recovery for women with an ischemic stroke or concerning the number of sessions attended was also highlighted. The use of gait robotics for female patients may favour a selective functional recovery after stroke.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

et al. 2021

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“…The present study cannot explain the mechanisms underlying these findings, but signifies the need for future studies investigating the effect of SET on women. Even though the importance of screening and treating women for atherosclerotic diseases is now widely acknowledged, our findings support the fact that women should equally be encouraged to participate in SET programs [ 32 , 33 , 34 , 35 ].…”

Section: Discussionsupporting

confidence: 70%

Multimodal Supervised Exercise Training Is Effective in Improving Long Term Walking Performance in Patients with Symptomatic Lower Extremity Peripheral Artery Disease

Ney

Lanzi

Calanca

et al. 2021

JCM

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This study aimed to evaluate the effect of a multimodal supervised exercise training (SET) program on walking performance for 12 months in patients with symptomatic lower extremity peripheral artery disease (PAD). Consecutive patients with Fontaine stage II PAD participating in the SET program of our hospital were retrospectively investigated. Walking performance, assessed using a treadmill with measures of the pain-free and maximal walking distance (PFWD, MWD, respectively), and 6 min walking distance (6MWD), were tested before and following SET, as well as at 6 and 12 months after SET completion. Ninety-three symptomatic patients with PAD (65.0 ± 1.1 y) were included in the study. Following SET, the walking performance significantly improved (PFWD: +145%, p ≤ 0.001; MWD: +97%, p ≤ 0.001; 6MWD: +15%, p ≤ 0.001). At 6 months, PFWD (+257%, p ≤ 0.001), MWD (+132%, p ≤ 0.001), and 6MWD (+11%, p ≤ 0.001) remained significantly improved compared with the pre-SET condition. At 12 months, PFWD (+272%, p ≤ 0.001), MWD (+130%, p ≤ 0.001), and 6MWD (+11%, p ≤ 0.001) remained significantly improved compared with the pre-training condition. The walking performance remained significantly improved in both women and men for up to 12 months (p ≤ 0.001). Multimodal SET is effective at improving walking performance in symptomatic patients with PAD, with improvements lasting up to 12 months.

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“…The present study demonstrated the sustainability of the program, which bypasses most barriers of the supervised programs [17,20]. The program is without gender differences [39] or limitations from pre-existing osteoarticular pathologies [40] and enables the enrolment of frail patients with restricted mobility. This exercise is based on over-ground personalized walking sessions inside the home and it is safe and painless [19].…”

Section: Discussionmentioning

confidence: 70%

Rehabilitative Exercise Reduced the Impact of Peripheral Artery Disease on Vascular Outcomes in Elderly Patients with Claudication: A Three-Year Single Center Retrospective Study

Manfredini

Lamberti

Guerzoni

et al. 2019

JCM

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The study retrospectively evaluated the association between rehabilitative outcomes and risk of peripheral revascularizations in elderly peripheral artery disease (PAD) patients with claudication. Eight-hundred thirty-five patients were enrolled. Ankle-brachial index (ABI) and maximal walking speed (Smax) were measured at baseline and at discharge from a structured home-based rehabilitation program. For the analysis, patients were divided according to a baseline ABI value (severe: ≤0.5; moderate: ≥0.5) and according to hemodynamic or functional rehabilitative response (responder: ABI ≥0.10 and/or Smax >0.5 km/h). Three-year outcomes were collected from the regional registry. According to the inclusion criteria (age 60–80, ABI <0.80; program completion) 457 patients, 146 severe and 311 moderate, were studied. The whole population showed significant functional and hemodynamic improvements at discharge, with 56 revascularizations and 69 deaths at follow-up. Compared to the moderate group, the severe group showed a higher rate of revascularizations (17% vs. 10%, p < 0.001) and deaths (29% and 8%, respectively; p < 0.001). However, patients with severe PAD who were ABI responders after rehabilitation showed less revascularizations than non-responders (13% vs. 21%; hazard ratio (HR): 0.52) and were not different from patients with moderate disease (9%). Superimposable rates were observed for Smax responders (13% vs. 21%; HR: 0.55; moderate 10%). In conclusion, elderly patients with severe PAD empowered by better rehabilitation outcomes showed lower rates of peripheral revascularizations and deaths that were comparable to patients with moderate PAD.

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Gender Differences in Outcomes Following a Pain-Free, Home-Based Exercise Program for Claudication

Abstract: A personalized, structured pain-free exercise program for PAD patients performed inside the home for a few minutes a day was equally effective in both sexes. Programs favoring adherence and functional outcomes in women should be tested in prospective studies.

Cited by 25 publications

References 53 publications

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

Beneficial Effects of Robot-Assisted Gait Training on Functional Recovery in Women after Stroke: A Cohort Study

Multimodal Supervised Exercise Training Is Effective in Improving Long Term Walking Performance in Patients with Symptomatic Lower Extremity Peripheral Artery Disease

Rehabilitative Exercise Reduced the Impact of Peripheral Artery Disease on Vascular Outcomes in Elderly Patients with Claudication: A Three-Year Single Center Retrospective Study

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