Safety of supervised exercise therapy in patients with intermittent claudication

Gommans, Lindy N.M.; Fokkenrood, H.J.P.; Dalen, H.C.W. van; Scheltinga, Marc R.; Teijink, Joep A.W.; Peters, Ron J.G.

doi:10.1016/j.jvs.2014.08.070

Cited by 72 publications

(51 citation statements)

References 92 publications

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“…The risk–benefit ratio for supervised exercise in PAD is favorable, with an excellent safety profile in patients screened for absolute contraindications to exercise such as exercise-limiting cardiovascular disease, amputation or wheelchair confinement, and other major comorbidities that would preclude exercise. 24,27,37,171–174 …”

Section: Structured Exercise Therapy: Recommendationsmentioning

confidence: 99%

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

et al. 2017

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Preamble Since 1980, the American College of Cardiology (ACC) and American Heart Association (AHA) have translated scientific evidence into clinical practice guidelines with recommendations to improve cardiovascular health. These guidelines, based on systematic methods to evaluate and classify evidence, provide a cornerstone of quality cardiovascular care. In response to reports from the Institute of Medicine1,2 and a mandate to evaluate new knowledge and maintain relevance at the point of care, the ACC/AHA Task Force on Clinical Practice Guidelines (Task Force) modified its methodology.3–5 The relationships among guidelines, data standards, appropriate use criteria, and performance measures are addressed elsewhere.5 Intended Use Practice guidelines provide recommendations applicable to patients with or at risk of developing cardiovascular disease. The focus is on medical practice in the United States, but guidelines developed in collaboration with other organizations may have a broader target. Although guidelines may be used to inform regulatory or payer decisions, the intent is to improve quality of care and align with patients' interests. Guidelines are intended to define practices meeting the needs of patients in most, but not all, circumstances, and should not replace clinical judgment. Guidelines are reviewed annually by the Task Force and are official policy of the ACC and AHA. Each guideline is considered current until it is updated, revised, or superseded by published addenda, statements of clarification, focused updates, or revised full-text guidelines. To ensure that guidelines remain current, new data are reviewed biannually to determine whether recommendations should be modified. In general, full revisions are posted in 5-year cycles.3–6 Modernization Processes have evolved to support the evolution of guidelines as “living documents” that can be dynamically updated. This process delineates a recommendation to address a specific clinical question, followed by concise text (ideally <250 words) and hyperlinked to supportive evidence. This approach accommodates time constraints on busy clinicians and facilitates easier access to recommendations via electronic search engines and other evolving technology. Evidence Review Writing committee members review the literature; weigh the quality of evidence for or against particular tests, treatments, or procedures; and estimate expected health outcomes. In developing recommendations, the writing committee uses evidence-based methodologies that are based on all available data.3–7 Literature searches focus on randomized controlled trials (RCTs) but also include registries, nonrandomized comparative and descriptive studies, case series, cohort studies, systematic reviews, and expert opinion. Only selected references are cited. The Task Force recognizes the need for objective, independent Evidence Review Committees (ERCs) that include methodologists, epidemiologists, clinicians, and biostatisticians who systematically survey, abstract, and assess the evidence t...

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Section: Structured Exercise Therapy: Recommendationsmentioning

confidence: 99%

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

et al. 2017

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“…A recent review analyzed the safety of supervised exercise training in patients with intermittent claudication (Gommans et al., ). There has been concern regarding the safety of performing supervised exercise training because intermittent claudication patients are at risk for cardiovascular events.…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Pedersen

Saltin

2015

Scandinavian Med Sci Sports

2,590

1,786

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This review provides the reader with the up‐to‐date evidence‐based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo‐skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

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“…Długoter-minowe korzyści z leczenia wysiłkiem są mniej jasne i zależą w znacznym stopniu od przestrzegania zaleceń terapeutycznych przez pacjenta. Nadzorowane leczenie wysiłkiem fizycznym jest bezpieczne i przed jego rozpoczęciem nie jest wymagana rutynowa przesiewowa ocena w kierunku chorób serca [270]. Takie leczenie jest również bardziej efektywne kosztowo niż leczenie nienadzorowane [271], ale nie wszędzie jest refundowane lub dostępne.…”

Section: Leczenie Wysiłkiem Fizycznymunclassified

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

Aboyans¹,

Ricco²,

Bartelink³

et al. 2017

Kardiol Pol

230

241

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Safety of supervised exercise therapy in patients with intermittent claudication

Cited by 72 publications

References 92 publications

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS)

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