Document Detail


Exercise rehabilitation programs for the treatment of claudication pain. A meta-analysis.
MedLine Citation:
PMID:  7674529     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To identify the components of exercise rehabilitation programs that were most effective in improving claudication pain symptoms in patients with peripheral arterial disease. DATA SOURCES: English-language articles were identified by a computer search using Index Medicus and MEDLINE, followed by an extensive bibliography review. STUDY SELECTION: Studies were included if they provided the mean or individual walking distances or times to the onset of claudication pain and to maximal pain during a treadmill test before and after rehabilitation. DATA EXTRACTION: Walking distances and times and characteristics of the exercise programs were independently abstracted by two observers. DATA SYNTHESIS: Thirty-three English-language studies were identified, of which 21 met the inclusion criteria. Overall, following a program of exercise rehabilitation, the distance (mean +/- SD) to onset of claudication pain increased 179% from 125.9 +/- 57.3 m to 351.2 +/- 188.7 m (P < .001), and the distance to maximal claudication pain increased 122% from 325.8 +/- 148.1 m to 723.3 +/- 591.5 m (P < .001). The greatest improvement in pain distances occurred with the following exercise program: duration greater than 30 minutes per session, frequency of at least three sessions per week, walking used as the mode of exercise, use of near-maximal pain during training as claudication pain end point, and program length of greater than 6 months. However, the claudication pain end point, program length, and mode of exercise were the only independent predictors (P < .001) for improvement in distances. CONCLUSIONS: The optimal exercise program for improving claudication pain distances in patients with peripheral arterial disease uses intermittent walking to near-maximal pain during a program of at least 6 months. Such a program should be part of the standard medical care for patients with intermittent claudication.
Authors:
A W Gardner; E T Poehlman
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  274     ISSN:  0098-7484     ISO Abbreviation:  JAMA     Publication Date:  1995 Sep 
Date Detail:
Created Date:  1995-10-17     Completed Date:  1995-10-17     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  975-80     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Claude Pepper Older Americans Independence Center, University of Maryland at Baltimore, USA.
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MeSH Terms
Descriptor/Qualifier:
Exercise Test
Exercise Therapy*
Humans
Intermittent Claudication / physiopathology,  therapy*
Models, Statistical
Pain Measurement
Peripheral Vascular Diseases / physiopathology
Walking
Grant Support
ID/Acronym/Agency:
K01-AG-00657/AG/NIA NIH HHS; K07-AG-00608/AG/NIA NIH HHS; R01-AG-07857/AG/NIA NIH HHS
Comments/Corrections
Comment In:
ACP J Club. 1996 Mar-Apr;124(2):37
JAMA. 1996 Feb 21;275(7):519-20   [PMID:  8606471 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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