Supervised exercise therapy for intermittent claudication in a community-based setting is as effective as clinic-based

Bendermacher, B.L.; Willigendael, Edith M.; Nicolaï, S.P.A.; Kruidenier, Lotte M.; Welten, R.J.Th.J.; Hendriks, Erik; Prins, Martin H.; Teijink, Joep A.W.; Bie, Robert de

doi:10.1016/j.jvs.2007.01.059

Cited by 63 publications

(60 citation statements)

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“…The dropout rate and unwillingness of some patients to participate arose from distance between their homes and hospital and unavailability of transportation. The development of a community-based SEP may improve treatment compliance, and a recent study has demonstrated the efficacy 28 and the costeffectiveness of such an approach. 9 …”

Section: Complications and Attritionmentioning

confidence: 99%

Early Outcomes From a Randomized, Controlled Trial of Supervised Exercise, Angioplasty, and Combined Therapy in Intermittent Claudication

Mazari

Gulati

Rahman

et al. 2010

Annals of Vascular Surgery

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Section: Complications and Attritionmentioning

confidence: 99%

Early Outcomes From a Randomized, Controlled Trial of Supervised Exercise, Angioplasty, and Combined Therapy in Intermittent Claudication

Mazari

Gulati

Rahman

et al. 2010

Annals of Vascular Surgery

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“…8,9 Most studies compared the efficacy of various types of SET to controls receiving pharmacologic therapy or a revascularization procedure. 8,[10][11][12][13] However, genderspecific outcomes after SET for patients with IC are seldom reported, and results are conflicting. [14][15][16] Two studies suggested that gender did not influence walking performance 14 and that both sexes equally benefited from SET.…”

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confidence: 99%

Gender differences following supervised exercise therapy in patients with intermittent claudication

Gommans

Scheltinga

Sambeek

et al. 2015

Journal of Vascular Surgery

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“…Furthermore, attending at the hospital for two or three times a week is time consuming and expensive for the patient. These disadvantages can be overcome using a community-based approach, consisting of a selected group of community-based physiotherapists especially trained in applying exercise therapy.Several studies have highlighted the equal effectiveness of community-based SET programms compared to the traditional health care unit-based SET approach [18,19]. Additionally, this approach has no restrictions of limited unit capacity, no transportation difficulties whereas recorded drop-out rates from the traditional SET programs reach almost 43% in literature [19].…”

mentioning

confidence: 99%

“…Several studies have highlighted the equal effectiveness of community-based SET programms compared to the traditional health care unit-based SET approach [18,19]. Additionally, this approach has no restrictions of limited unit capacity, no transportation difficulties whereas recorded drop-out rates from the traditional SET programs reach almost 43% in literature [19].…”

mentioning

confidence: 99%

“…Additionally, this approach has no restrictions of limited unit capacity, no transportation difficulties whereas recorded drop-out rates from the traditional SET programs reach almost 43% in literature [19]. However, a possible disadvantage of community-based SET could be the large number of participating physiotherapists, leading to a lower volume of patients and less experience per physiotherapist.…”

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Exercise Therapy in Patients with Intermittent Claudication

2015

J Nov Physiother

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EditorialPeripheral artery disease (PAD) has been associated with specific risk factors such as smoking, diabetes mellitus (DM) as well as previous coronary and cerebrovascular disease [1]. Furthermore, PAD has been correlated to an increased risk for cardiovascular morbidity and mortality [2,3]. Although the most common symptom of PAD is intermittent claudication, recent data reveal that asymptomatic PAD is several times more common in the general population [1]. Therefore, modification of atherosclerosis risk factors as well as exercise therapy are strongly recommended as first-line treatment by recent guidelines [4].Patients with history of PAD experience significant limitation in everyday physical activities and walking, in particular [5,6]. In a recent study of more than 2,000 patients with suspected or known PAD, de Liefde et al have highlighted the prognostic value of impared walking distance on long-term major cardiovascular events [7]. In such patients, measurement of ankle brachial index (ABI) remains a valuable diagnostic and prognostic tool. ABI is an independent risk factor for cardiovascular diseases and mortality, even in asymptomatic patients [8,9]. Finally, there is recent evidence correlating abnormal measurements of ABI (< 0.9 or > 1.4) with silent cerebral small vessel disease [10] and a higher risk for presenting stroke in general population [11].Regarding the effect of physical activity on reducing symptoms and cardiovascular risk in PAD patients, several studies have shown that exercise has a known positive influence on vascular risk factors such as hypertension, hypercholesterolemia, and diabetes mellitus [12]. Furthermore, reports show that patients with PAD (or more specifically, intermittent claudication) who are physically active are less likely to die compared with a group of sedentary patients with PAD [13]. After adjustments for age, ABI, and body mass index, these results are similar in patients with intermittent claudication [13]. Research data clearly indicate that exercise treatment can improve walking distance and therefore, it is recommended in recent guidelines [4]. However, type and duration of exercise remains still under investigation.The most common exercise therapy prescription consists of onetime oral advice to walk more, usually without supervision or followup. However, there is no evidence to support the efficacy of this advice, and compliance is known to be low [14]. Several factors such as fear against pain, inadequate knowledge of the underlying disease, and poor general condition, contribute to the difficulty of starting, sustaining, and maintaining exercise therapy as indicated. Therefore, the importance of supervised exercise therapy (SET) is increasingly recognized. SET includes adequate coaching to increase the maximal walking distance as well as coaching in the necessary lifestyle changes, such as smoking cessation, weight control, and increase in overall exercise. A recent Cochrane Review has identified a significant improvement in walking distance in patie...

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Supervised exercise therapy for intermittent claudication in a community-based setting is as effective as clinic-based

Abstract: Supervised exercise therapy in a community-based setting is a promising approach to providing conservative treatment for patients with intermittent claudication.

Cited by 63 publications

References 13 publications

Early Outcomes From a Randomized, Controlled Trial of Supervised Exercise, Angioplasty, and Combined Therapy in Intermittent Claudication

Early Outcomes From a Randomized, Controlled Trial of Supervised Exercise, Angioplasty, and Combined Therapy in Intermittent Claudication

Gender differences following supervised exercise therapy in patients with intermittent claudication

Exercise Therapy in Patients with Intermittent Claudication

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