Document Detail


Supervised exercise therapy for intermittent claudication in a community-based setting is as effective as clinic-based.
MedLine Citation:
PMID:  17543684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This cohort study was conducted to determine the effect on walking distances of supervised exercise therapy provided in a community-based setting.
METHODS: The study included all consecutive patients presenting at the vascular outpatient clinic with intermittent claudication, diagnosed by a resting ankle brachial index<0.9, who had no previous peripheral vascular intervention for peripheral arterial disease, no major amputation, and sufficient command of the Dutch language. The exclusion criterion was the inability to walk the baseline treadmill test for a minimum of 10 m. The intervention was a supervised exercise therapy in a community-based setting. A progressive treadmill test at baseline and at 1, 3, and 6 months of follow-up measured initial claudication distance and absolute claudication distance. Changes were calculated using the mean percentages of change.
RESULTS: From January through October 2005, 93 consecutive patients with claudication were eligible. Overall, 37 patients discontinued the supervised exercise therapy program. Eleven stopped because of intercurrent diseases, whereas for 10, supervised exercise therapy did not lead to adequate improvement and they underwent a vascular intervention. Three patients quit the program, stating that they were satisfied with the regained walking distance and did not require further supervised exercise therapy. Ten patients were not motivated sufficiently to continue the program, and in three patients, a lack of adequate insurance coverage was the reason for dropping out. Data for 56 patients were used and showed a mean percentage increase in initial claudication distance of 187% after 3 months and 240% after 6 months. The mean percentage of the absolute claudication distance increased 142% after 3 months and 191% after 6 months.
CONCLUSION: Supervised exercise therapy in a community-based setting is a promising approach to providing conservative treatment for patients with intermittent claudication.
Authors:
Bianca L Bendermacher; Edith M Willigendael; Saskia P Nicolaï; Lotte M Kruidenier; Rob J Welten; Erik Hendriks; Martin H Prins; Joep A W Teijink; Robert A de Bie
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  45     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-06-04     Completed Date:  2007-07-13     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1192-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Atrium Medical Centre, Heerlen, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care Facilities*
Ankle / blood supply
Blood Pressure
Brachial Artery / physiopathology
Cohort Studies
Community Health Services*
Exercise Therapy*
Humans
Intermittent Claudication / etiology,  physiopathology,  therapy*
Netherlands
Patient Compliance
Patient Dropouts
Peripheral Vascular Diseases / complications*,  physiopathology,  therapy
Time Factors
Treatment Outcome
Walking*

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


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