Additional Supervised Exercise Therapy After a Percutaneous Vascular Intervention for Peripheral Arterial Disease: A Randomized Clinical Trial

2012 ◽  
Vol 2012 ◽  
pp. 178-179
Author(s):  
G.L. Moneta
Keyword(s):  
Clinical Trial ◽  
Peripheral Arterial Disease ◽  
Randomized Clinical Trial ◽  
Exercise Therapy ◽  
Arterial Disease ◽  
Vascular Intervention ◽  
Supervised Exercise ◽  
Peripheral Arterial

scholarly journals Protocol for a prospective, longitudinal cohort study on the effect of arterial disease level on the outcomes of supervised exercise in intermittent claudication: the ELECT Registry

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e025419 ◽  
Author(s):  
Marijn ML van den Houten ◽  
Sandra CP Jansen ◽  
Anneroos Sinnige ◽  
Lijckle van der Laan ◽  
Patrick WHE Vriens ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Imaging Modality ◽  
Arterial Disease ◽  
Invasive Treatment ◽  
Supervised Exercise ◽  
Peripheral Arterial ◽  
Prospective Longitudinal

IntroductionDespite guideline recommendations advocating conservative management before invasive treatment in intermittent claudication, early revascularisation remains widespread in patients with favourable anatomy. The aim of the Effect of Disease Level on Outcomes of Supervised Exercise in Intermittent Claudication Registry is to determine the effect of the location of stenosis on the outcomes of supervised exercise in patients with intermittent claudication due to peripheral arterial disease.Methods and analysisThis multicentre prospective cohort study aims to enrol 320 patients in 10 vascular centres across the Netherlands. All patients diagnosed with intermittent claudication (peripheral arterial disease: Fontaine II/Rutherford 1–3), who are considered candidates for supervised exercise therapy by their own physicians are appropriate to participate. Participants will receive standard care, meaning supervised exercise therapy first, with endovascular or open revascularisation in case of insufficient effect (at the discretion of patient and vascular surgeon). For the primary objectives, patients are grouped according to anatomical characteristics of disease (aortoiliac, femoropopliteal or multilevel disease) as apparent on the preferred imaging modality in the participating centre (either duplex, CT angiography or magnetic resonance angiography). Changes in walking performance (treadmill tests, 6 min walk test) and quality of life (QoL; Vascular QoL Questionnaire-6, WHO QoL Questionnaire-Bref) will be compared between groups, after multivariate adjustment for possible confounders. Freedom from revascularisation and major adverse cardiovascular disease events, and attainment of the treatment goal between anatomical groups will be compared using Kaplan-Meier survival curves.Ethics and disseminationThis study has been exempted from formal medical ethical approval by the Medical Research Ethics Committees United ‘MEC-U’ (W17.071). Results are intended for publication in peer-reviewed journals and for presentation to stakeholders nationally and internationally.Trial registration numberNTR7332; Pre-results.

Supervised exercise therapy in the management of peripheral arterial disease – an assessment of compliance

VASA ◽  
2017 ◽  
Vol 46 (3) ◽  
pp. 219-222 ◽  
Author(s):  
Thomas M. Aherne ◽  
Elrasheid A. H. Kheirelseid ◽  
Michael Boland ◽  
Shane Carr ◽  
Thekra Al-Zabi ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Exercise Therapy ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Symptomatic Improvement ◽  
Smoking History ◽  
Supervised Exercise ◽  
Exercise Compliance ◽  
The Mean ◽  
Peripheral Arterial

Abstract. Background: Supervised exercise therapy (SET) is an effective option in the management of peripheral arterial disease (PAD). Unfortunately, poor compliance remains prevalent. This study aimed to assess patient exercise compliance and to identify factors influencing symptomatic improvement and SET participation. Patients and methods: Data regarding attendance at SET for this cohort study were extracted from a prospectively maintained database of patients with claudication attending SET at Dublin City University. All patients had ankle brachial index confirmed PAD with associated intermittent claudication. Exercise performance and symptomatic data were gathered retrospectively using patient charts and interviews. Results: Ninety-eight patients were referred for SET during the study period. The mean age was 69.2 (± 10.1) with 18 % being female. Median follow-up was 25.1 months (IQ range 17.0–31.6). Overall, the mean number of sessions attended per patient was 19.5. Exercise compliance was associated with a significant improvement in symptoms (p = 0.001). Other factors including anatomical level of claudication (P = 0.042) and educational level (p = 0.007) were found to affect the outcome of SET. Multivariate analysis revealed hypertension as a predictor of symptomatic outcome after SET (p = 0.045). Furthermore, ex-smokers (p = 0.021) and those previously diagnosed with hypercholesterolaemia (p = 0.020) or ischaemic heart disease (p = 0.029) had superior exercise compliance. Using linear regression, smoking history (p = 0.024) was identified as a predictor of compliance to SET. Conclusions: Establishing exercise compliance remains challenging in the PAD cohort. Pre-exercise patient education and personalised exercise prescriptions may result in improvements in function and compliance.

scholarly journals Effects of modified aerobic training on muscle metabolism in individuals with peripheral arterial disease: a randomized clinical trial

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Débora Pantuso Monteiro ◽  
Giane Amorim Ribeiro-Samora ◽  
Raquel Rodrigues Britto ◽  
Danielle Aparecida Gomes Pereira
Keyword(s):  
Clinical Trial ◽  
Peripheral Arterial Disease ◽  
Randomized Clinical Trial ◽  
Near Infrared ◽  
Aerobic Training ◽  
Muscle Metabolism ◽  
Arterial Disease ◽  
Primary Objective ◽  
Lower Limbs ◽  
Peripheral Arterial

Abstract The primary objective of this study was to compare the effects on muscle metabolism of two types of aerobic training, with and without a load on the lower limbs, in adults with peripheral arterial disease (PAD). A simple blind randomized clinical trial was conducted using two groups: conventional aerobic (CG) and modified aerobic with a load on the lower limbs (MG). Both groups underwent training by walking three times a week over a 12-week period. The ratings of muscle metabolism were determined after a treadmill test with constant velocity and inclination concomitant with the use of near infrared spectroscopy (NIRS). Altogether 40 individuals with PAD (CG = 65.45 ± 10.60 and MG = 63.10 ± 10.54) were included in the study. After the intervention, in both groups, there was a reduction in the relative time to recovery (p = 0.002), an improvement in the re-oxygenation rate (p = 0.017), an increased time of resistance after reaching the lowest muscle oxygen saturation (StO2) (p < 0.001), an increase in the distance walked (p < 0.001), and an improvement of the walking economy relative to StO2 (p < 0.001). After 12 weeks of training, an improvement in the deoxygenation rate was observed in both groups (p = 0.002), but with a greater magnitude in the CG (p = 0.017). Only the CG presented an increase in time to reach the lowest StO2 on the treadmill after the intervention (p = 0.010). The traditional aerobic training was superior to the modified training in relation to the improvement of muscle metabolism in patients with PAD.

scholarly journals Peripheral Vascular Intervention: A Review

2019 ◽  
Vol 34 (1) ◽  
pp. 58-67
Author(s):  
Mohsin Ahmed ◽  
Abul Hasan Muhammed Bashar ◽  
Abdullah Al Gaddafi
Keyword(s):  
Peripheral Arterial Disease ◽  
Peripheral Artery Disease ◽  
Exercise Program ◽  
Arterial Disease ◽  
Peripheral Artery ◽  
Vascular Intervention ◽  
Long Term Outcome ◽  
Supervised Exercise ◽  
Artery Disease ◽  
Peripheral Arterial

The prevalence of peripheral artery disease (PAD) continues to increase worldwide. It is important to identify patients with PAD because of the increased risk of myocardial infarction, stroke, and cardiovascular death and impaired quality of life because of a profound limitation in exercise performance.Lower extremity PAD affects approximately 10% of population, with 30% to 40% of these patients presenting with claudication symptoms. Peripheral arterial disease is common, but the diagnosis frequently is overlooked because of subtle physical findings and lack of classic symptoms. Screening based on the ankle brachial index using doppler ultrasonography may be more useful than physical examination alone. Noninvasive modalities to locate lesions include duplex scanning, computed tomography angiogram, magnetic resonance angiography and invasive modalities peripheral angiogram is the gold standard. Major risk factors for peripheral arterial disease are cigarette smoking, diabetes mellitus, older age (older than 40 years), hypertension, hyperlipidemia, and hyperhomocystinemia. Intermittent claudication may be improved by risk-factor modification, exercise, and pharmacologic therapy. Based on available evidence, a supervised exercise program is the most effective treatment. Effective drug therapies for peripheral arterial disease include aspirin (with or without dipyridamole), clopidogrel, cilostazol, and pentoxifylline. By contrast, critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels. It is associated with a high risk of major amputation, cardiovascular events and death. The management of CLI should include an exercise program, guideline-based medical therapy to lower the cardiovascular risk. Most of the cases, revascularization is indicated to save limbs; an “endovascular first” approach and lastly surgical approach, if all measures were failed. The choice of the intervention is dependent on the anatomy of the stenotic or occlusive lesion; percutaneous interventions are appropriate when the lesion is focal and short but longer lesions must be treated with surgical revascularisation to achieve acceptable long-term outcome. Bangladesh Heart Journal 2019; 34(1) : 58-67

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