scholarly journals A Three Month Home Exercise Programme Augmented with Nordic Poles for Patients with Intermittent Claudication Enhances Quality of Life and Continues to Improve Walking Distance and Compliance After One Year

2017 ◽  
Vol 53 (5) ◽  
pp. 704-709 ◽  
Author(s):  
C. Oakley ◽  
C. Spafford ◽  
J.D. Beard
Keyword(s):  
Quality Of Life ◽  
Intermittent Claudication ◽  
Exercise Programme ◽  
Walking Distance ◽  
Home Exercise ◽  
Home Exercise Programme ◽  
One Year

scholarly journals Long-term exercise maintenance in COPD via telerehabilitation: a two-year pilot study

2016 ◽  
Vol 23 (1) ◽  
pp. 74-82 ◽  
Author(s):  
Paolo Zanaboni ◽  
Hanne Hoaas ◽  
Linda Aarøen Lien ◽  
Audhild Hjalmarsen ◽  
Richard Wootton
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Physical Performance ◽  
Walking Distance ◽  
Home Exercise ◽  
Clinical Effects ◽  
Exercise Maintenance ◽  
One Year

Introduction Pulmonary rehabilitation (PR) is an integral part of the management of chronic obstructive pulmonary disease (COPD). However, many patients do not access or complete PR, and long-term exercise maintenance has been difficult to achieve after PR. This study aimed to investigate feasibility, long-term exercise maintenance, clinical effects, quality of life and use of hospital resources of a telerehabilitation intervention. Methods Ten patients with COPD were offered a two-year follow-up via telerehabilitation after attending PR. The intervention consisted of home exercise, telemonitoring and self-management via a webpage combined with weekly videoconferencing sessions. Equipment included a treadmill, a pulse oximeter and a tablet. Data collected at baseline, one year and two years were six-minute walking distance (6MWD), COPD assessment test (CAT), EuroQol 5 dimensions (EQ-5D), hospitalisations and outpatient visits. Results No dropout occurred. Physical performance, lung capacity, health status and quality of life were all maintained at two years. At one year, 6MWD improved by a mean of 40 metres from baseline, CAT decreased by four points and EQ visual analogue scale (EQ VAS) improved by 15.6 points. Discussion Long-term exercise maintenance in COPD via telerehabilitation is feasible. Results are encouraging and suggest that telerehabilitation can prevent deterioration and improve physical performance, health status and quality of life.

scholarly journals A prospective observational cohort study considering the feasibility and tolerability of high intensity interval training as a novel treatment therapy for patients with intermittent claudication

2020 ◽  
Author(s):  
Sean Pymer ◽  
Said Ibeggazene ◽  
Joanne Palmer ◽  
George E. Smith ◽  
Amy E. Harwood ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intermittent Claudication ◽  
High Intensity ◽  
Exercise Prescription ◽  
Interval Training ◽  
Walking Distance ◽  
Completion Rates ◽  
High Intensity Interval Training ◽  
High Intensity Interval

AbstractBackgroundUptake and completion rates for supervised exercise programmes (SEP) for patients with intermittent claudication (IC) are low. Current exercise prescription is a one size fits all approach, based on claudication pain thresholds, potentially limiting individual benefits. High-intensity interval training (HIIT) has the potential to overcome these barriers as it is a more time-efficient, objectively prescribed exercise programme. This study aimed to assess a novel HIIT programme for patients with IC in terms of safety, feasibility, tolerability and indicators of efficacy.Design/MethodsPatients referred to a usual-care SEP were invited to undertake an alternative HIIT programme. All recruited patients performed a baseline cardiopulmonary exercise test (CPET), to inform their exercise prescription. HIIT involved ten, one-minute high-intensity intervals on a stationary cycle ergometer interspersed with one-minute recovery intervals, performed three times per week for six-weeks. Outcomes included safety, feasibility, tolerability, walking distance and quality of life (QoL).Results144 patients with IC were referred, 95 met initial eligibility criteria (66%) and 30 (32%) were recruited for HIIT, of which 15 (50%) completed. Of the recruited patients, 90% were on optimal medical therapy and 40% had concomitant cardiac, cerebrovascular and/or respiratory disease.One serious adverse event was recorded and patients who completed the programme attended 100% of the sessions. Improvements in walking distances and quality of life were observed. Following recruitment of the first 20 patients, the inclusion criteria was refined on the basis of CPET, leading to improved completion rates.ConclusionThe study provides preliminary findings indicating that patients with IC can complete a short-term HIIT programme. HIIT also appears safe, well-tolerated and although not formally powered, walking distances and QoL appear to improve following HIIT. Further research to evaluate the role of HIIT in patients with IC seems warranted.

scholarly journals Improving Rehabilitation for Patients with Intermittent Claudication: A Randomized Controlled Trial with a Mixed-Methods Evaluation (The CIPIC Rehab Study)

2021 ◽  
Author(s):  
Maj Siercke ◽  
Sanne Pagh Moller ◽  
Lau Caspar Thygesen ◽  
Henrik Sillesen ◽  
Dorthe Overgaard
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Clinical Trial ◽  
Mixed Methods ◽  
Usual Care ◽  
Randomized Clinical Trial ◽  
Intermittent Claudication ◽  
Walking Distance ◽  
Significant Difference

Aim: This study aimed to explore how qualitative data about rehabilitation for patients with intermittent claudication do provide an enhanced understanding of the quantitative experimental results. Background: The study was a randomized clinical trial comparing a rehabilitation intervention with usual care. A statistically significant difference between rehabilitation and usual care was found in walking distance, physical activity, quality of life and diet. The findings from the quantitative and qualitative analyses were analysed separately on their own tradition. In this study, mixed methods address whether the qualitative results could help explain the quantitative results and bring forward additional information. Design: Complex mixed-method intervention design with a convergent questionnaire variant. Methods: From April 2017- May 2019, patients diagnosed with intermittent claudication were included in a randomized clinical trial (N=118). In addition, qualitative interview informants from the intervention group were sampled from the quantitative study population for a survey (N=43) and focus group interviews (N=10). Interviews were conducted from April 2018-August 2019. Results: Integrated analyses identified how improvement in walking distance, physical activity, diet and quality of life was affected by team spirit, pedometer, education and fun exercise in a local setting. Quantitative and qualitative findings primarily confirmed and expanded each other; however, two discordant results were also evident. Conclusion: Our study adds empirical evidence regarding how a mixed-methods study can be used to obtain a more nuanced understanding of complex healthcare problems. The study provides new knowledge concerning how to set up a rehabilitation programme for patients with intermittent claudication.

EP.WE.197Feasibility of a remotely supervised exercise programme

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Matthew Machin ◽  
Laura Hayward ◽  
Lindsey Harris ◽  
Vijay Gadhvi ◽  
Ankur Thapar
Keyword(s):  
Quality Of Life ◽  
Smoking Cessation ◽  
Exercise Programme ◽  
Walking Distance ◽  
Specialist Nurse ◽  
Median Baseline ◽  
Supervised Exercise ◽  
Initial Appointment ◽  
Best Medical Therapy

Abstract Aim To assess feasibility of a novel remotely-supervised exercise programme at a vascular hub during the COVID-19 lockdown. Methods Participants with arterial claudication (ABPI <0.90) who were able to walk 50m were enrolled into a 3-month programme by a vascular specialist nurse. The initial appointment addressed smoking cessation and best medical therapy. Baseline walking distance, ABPI and quality of life (QoL) were measured using the Intermittent Claudication Questionnaire. Following this, up to 8 WhatsApp video calls with a vascular specialist physiotherapist were undertaken to provide a tailored exercise programme. The Mapmywalk© App, or a pedometer, were used to monitor walking distances. Participants were instructed to record their daily longest walk and email results to their physiotherapist before each consultation. Results 12 participants were enrolled, of these 2 participants were unsuitable. Median age was 63 years and 2 (20%) were female. Baseline median ABPI was 0.7 (IQR 0.5-0.8), median baseline absolute walking distance was 75m (IQR 50-140) and median baseline QoL was 51/80 (IQR 15-79). 7 participants (70%) successfully completed the programme and were discharged. Their median daily longest walk was 2000m (IQR 200-4000) and QoL scores improved to 6/80 (IQR 2-20) (p = 0.02). Remaining 3 participants required revascularisation for disease progression. Reimbursement tariffs for the supervised exercise programme were £700 per patient, whereas for revascularisation were £2000 - £5000. Conclusion Remotely supervised exercise was feasible and improved walking distance and quality of life in 70% of participants. Approximately £3000 per patient was saved from a reduction in revascularisation procedures in our unit.

Extracorporeal shockwave therapy for intermittent claudication: Medium-term outcomes from a double-blind randomised placebo-controlled pilot trial

Vascular ◽  
2018 ◽  
Vol 26 (5) ◽  
pp. 531-539 ◽  
Author(s):  
Jordan Luke Green ◽  
Amy Elizabeth Harwood ◽  
George Edward Smith ◽  
Tushar Das ◽  
Ali Raza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intermittent Claudication ◽  
Pilot Trial ◽  
Walking Distance ◽  
Medium Term ◽  
Double Blind ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

Objectives Peripheral arterial disease most commonly presents as intermittent claudication (IC). Early evidence has suggested that extracorporeal shockwave therapy is efficacious in the short term for the management of intermittent claudication. The objective of this pilot trial was to evaluate the medium-term efficacy of this treatment. Methods This double-blind randomised placebo-controlled pilot trial randomised patients with unilateral intermittent claudication in a 1:1 fashion to receive extracorporeal shockwave therapy or a sham treatment for three sessions per week over three weeks. Primary outcomes were maximum walking distance and intermittent claudication distance using a fixed-load treadmill test. Secondary outcomes included pre- and post-exertional ankle-brachial pressure indices, safety and quality of life assessed using generic (SF36, EQ-5D-3L) and disease-specific (vascular quality of life) measures. All outcome measures were assessed at 12 months post-treatment. Results Thirty participants were included in the study (extracorporeal shockwave therapy, n = 15; sham, n = 15), with 26 followed up and analysed at 12 months (extracorporeal shockwave therapy, n = 13; sham, n = 13). Intragroup analysis demonstrated significant improvements in maximum walking distance, intermittent claudication distance and post-exertional ankle-brachial pressure indices ( p < 0.05) in the active treatment group, with no improvements in pre-exertional ankle-brachial pressure indices. Significant improvements in quality of life were observed in 3 out of 19 domains assessed in the active group. A re-intervention rate of 26.7% was seen in both groups. Conclusions These findings suggest that extracorporeal shockwave therapy is effective in improving walking distances at 12 months. Although this study provides important pilot data, a larger study is needed to corroborate these findings and to investigate the actions of this treatment. ISRCTN: NCT02652078.

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