Is Supervised Exercise Therapy Alone Enough to Improve Intermittent Claudication, Physical Function and Quality of Life in Type II Diabetics?

2015 ◽  
Vol 47 ◽  
pp. 466
Author(s):  
Simon M. Fryer ◽  
Michael McCluskey ◽  
Eve Scarle ◽  
Keeron Stone ◽  
Diane Crone
Keyword(s):  
Quality Of Life ◽  
Physical Function ◽  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Type Ii ◽  
Supervised Exercise ◽  
Type Ii Diabetics

scholarly journals Treatment for intermittent claudication and the effects on walking distance and quality of life

Vascular ◽  
2012 ◽  
Vol 20 (1) ◽  
pp. 20-35 ◽  
Author(s):  
L M Kruidenier ◽  
W Viechtbauer ◽  
S P Nicolaï ◽  
H Büller ◽  
M H Prins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intermittent Claudication ◽  
Exercise Therapy ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Walking Distance ◽  
Analysis Model ◽  
Physical Quality ◽  
Supervised Exercise

The objective of the study was to provide an overview of the most common treatments for intermittent claudication and to determine the effectiveness in improving walking distance and quality of life based on a combination of direct and indirect evidence. We included trials that compared: angioplasty, surgery, exercise therapy or no treatment for intermittent claudication. Outcome measurements were walking distance (maximum, pain-free) and quality of life (physical, mental). We used a network meta-analysis model for the combination of direct and indirect evidence. We included 42 studies, presenting 3106 participants. The network meta-analysis showed that supervised exercise therapy (Δ = 1.62, P < 0.01), angioplasty (Δ = 1.89, P < 0.01) and surgery (Δ = 2.72, P = 0.02) increased walking distance significantly more than no treatment. Furthermore, supervised exercise therapy (Δ = 0.60, P < 0.01), angioplasty (Δ = 0.91, P = 0.01) and surgery (Δ = 1.07, P < 0.01) increased physical quality of life more than no treatment. However, in the sensitivity analysis, only supervised exercise therapy had additional value over no symptomatic treatment (Δ = 0.66, P < 0.01). In conclusion, this network meta-analysis indicates that supervised exercise therapy is more effective in both increasing walking distance and physical quality of life, compared with no treatment. Angioplasty and surgery also increase walking distance, compared with no treatment, but results for physical quality of life are less convincing.

Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease

2021 ◽  
pp. 1-8
Author(s):  
Susan Matthews ◽  
Martin Fox ◽  
Sarah Coy ◽  
Jane Whittaker ◽  
Gail Brough ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Cardiac Rehabilitation ◽  
Intermittent Claudication ◽  
Arterial Disease ◽  
Morbidity And Mortality ◽  
Supervised Exercise ◽  
Peripheral Arterial

Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

scholarly journals Implementation of Supervised Exercise Therapy for Patients With Symptomatic Peripheral Artery Disease: A Science Advisory From the American Heart Association

Circulation ◽  
2019 ◽  
Vol 140 (13) ◽  
Author(s):  
Diane Treat-Jacobson ◽  
Mary M. McDermott ◽  
Joshua A. Beckman ◽  
Marsha A. Burt ◽  
Mark A. Creager ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Outcome Measurement ◽  
The United States ◽  
Walking Ability ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Artery Disease

Patients with lower-extremity peripheral artery disease (PAD) have greater functional impairment, faster functional decline, increased rates of mobility loss, and poorer quality of life than people without PAD. Supervised exercise therapy (SET) improves walking ability, overall functional status, and health-related quality of life in patients with symptomatic PAD. In 2017, the Centers for Medicare & Medicaid Services released a National Coverage Determination (CAG-00449N) for SET programs for patients with symptomatic PAD. This advisory provides a practical guide for delivering SET programs to patients with PAD according to Centers for Medicare & Medicaid Services criteria. It summarizes the Centers for Medicare & Medicaid Services process and requirements for referral and coverage of SET and provides guidance on how to implement SET for patients with PAD, including the SET protocol, options for outcome measurement, and transition to home-based exercise. This advisory is based on the guidelines established by the Centers for Medicare & Medicaid Services for Medicare beneficiaries in the United States and is intended to assist clinicians and administrators who are implementing SET programs for patients with PAD.

scholarly journals Distress and Quality of Life among Type II Diabetic Patients: Role of physical activity

2021 ◽  
Vol 16 (1) ◽  
pp. 64-74
Author(s):  
Devaraju Kadari ◽  
Gadiraju Padmaja ◽  
Binod Rajak
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Diabetes Management ◽  
Diabetic Patients ◽  
Type Ii ◽  
Snowball Sampling ◽  
Type Ii Diabetics ◽  
Group 2 ◽  
Group 1

This study measures the distress and Quality of Life (QoL) among people with type II diabetics in relation to physical exercise.  The study was conducted using diabetic participants chosen from various hospitals, aerobic centres, playgrounds and gyms in the city of Hyderabad in India.  The participants were divided into two groups – group 1 comprising people who did not adopt physical activity as part of their diabetes management strategy and group 2 comprising people who engaged in physical activity. A quasi-experimental study was performed on both groups employing purposive and snowball sampling methods. Pearson r showed that distress is negatively correlated with QoL among type II diabetics in both groups. Independent t-test indicated that participants in group 2 showed better QoL and lower levels of distress compared to their counterparts in group 1.

The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis

2016 ◽  
Vol 30 (12) ◽  
pp. 1141-1155 ◽  
Author(s):  
Kesava Kovanur Sampath ◽  
Ramakrishnan Mani ◽  
Takayuki Miyamori ◽  
Steve Tumilty
Keyword(s):  
Quality Of Life ◽  
Physical Function ◽  
Manual Therapy ◽  
Exercise Therapy ◽  
Meta Analysis ◽  
Hip Osteoarthritis ◽  
Post Treatment ◽  
Quality Evidence

Objective: To determine whether manual therapy or exercise therapy or both is beneficial for people with hip osteoarthritis in terms of reduced pain, improved physical function and improved quality of life. Methods: Databases such as Medline, AMED, EMBASE, CINAHL, SPORTSDiscus, PubMed, Cochrane Library, Web of Science, Physiotherapy Evidence Database, and SCOPUS were searched from their inception till September 2015. Two authors independently extracted and assessed the risk of bias in included studies. Standardised mean differences for outcome measures (pain, physical function and quality of life) were used to calculate effect sizes. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for assessing the quality of the body of evidence for each outcome of interest. Results: Seven trials (886 participants) that met the inclusion criteria were included in the meta-analysis. There was high quality evidence that exercise therapy was beneficial at post-treatment (pain-SMD-0.27,95%CI-0.5to-0.04;physical function-SMD-0.29,95%CI-0.47to-0.11) and follow-up (pain-SMD-0.24,95%CI- 0.41to-0.06; physical function-SMD-0.33,95%CI-0.5to-0.15). There was low quality evidence that manual therapy was beneficial at post-treatment (pain-SMD-0.71,95%CI-1.08to-0.33; physical function-SMD-0.71,95%CI-1.08to-0.33) and follow-up (pain-SMD-0.43,95%CI-0.8to-0.06; physical function-SMD-0.47,95%CI-0.84to-0.1). Low quality evidence indicated that combined treatment was beneficial at post-treatment (pain-SMD-0.43,95%CI-0.78to-0.08; physical function-SMD-0.38,95%CI-0.73to-0.04) but not at follow-up (pain-SMD0.25,95%CI-0.35to0.84; physical function-SMD0.09,95%CI-0.5to0.68). There was no effect of any interventions on quality of life. Conclusion: An Exercise therapy intervention provides short-term as well as long-term benefits in terms of reduction in pain, and improvement in physical function among people with hip osteoarthritis. The observed magnitude of the treatment effect would be considered small to moderate.

scholarly journals Cardiac Rehabilitation in Patients with Peripheral Artery Disease—A Literature Review in COVID-19 Era

2022 ◽  
Vol 11 (2) ◽  
pp. 416
Author(s):  
Razvan Anghel ◽  
Cristina Andreea Adam ◽  
Dragos Traian Marius Marcu ◽  
Ovidiu Mitu ◽  
Florin Mitu
Keyword(s):  
Quality Of Life ◽  
Cardiac Rehabilitation ◽  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Peripheral Artery ◽  
Rehabilitation Programs ◽  
Supervised Exercise ◽  
Effective Manner ◽  
Artery Disease

Cardiac rehabilitation (CR) is an integral part of the management of various cardiovascular disease such as coronary artery disease (CAD), peripheral artery disease (PAD), or chronic heart failure (CHF), with proven morbidity and mortality benefits. This article aims to review and summarize the scientific literature related to cardiac rehabilitation programs for patients with PAD and how they were adapted during the COVID-19 pandemic. The implementation of CR programs has been problematic since the COVID-19 pandemic due to social distancing and work-related restrictions. One of the main challenges for physicians and health systems alike has been the management of PAD patients. COVID-19 predisposes to coagulation disorders that can lead to severe thrombotic events. Home-based walking exercises are more accessible and easier to accept than supervised exercise programs. Cycling or other forms of exercise are more entertaining or challenging alternatives to exercise therapy. Besides treadmill exercises, upper- and lower-extremity ergometry also has great functional benefits, especially regarding walking endurance. Supervised exercise therapy has a positive impact on both functional capacity and also on the quality of life of such patients. The most effective manner to acquire this seems to be by combining revascularization therapy and supervised exercise. Rehabilitation programs proved to be a mandatory part of the integrative approach in these cases, increasing quality of life, and decreasing stress levels, depression, and anxiety.

Long-term effects of supervised exercise training on walking capacity and quality of life in patients with intermittent claudication

VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 250-256 ◽  
Author(s):  
Keo ◽  
Grob ◽  
Guggisberg ◽  
Widmer ◽  
Baumgartner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Exercise Training ◽  
Intermittent Claudication ◽  
Long Term Effects ◽  
Supervised Exercise ◽  
Exercise Training Program ◽  
Walking Capacity

Supervised exercise training has been shown to improve walking capacity in several studies of patients with intermittent claudication. However, data on long-term outcome are quite limited. The aim of this prospective study was to evaluate long-term effects of supervised exercise training on walking capacity and quality of life in patients with intermittent claudication. Patients and methods: Sixty-seven consecutive patients with intermittent claudication who completed a supervised 12-week exercise training program were asked for follow up evaluation 39 ± 20 months after program completion. Pain-free walking distance (PWD) and maximum walking distances (MWD) were assessed by treadmill test and several questionnaires. Results: Forty (60%) patients agreed to participate, 22 (33%) refused participation, and 5 (7%) died during follow-up. PWD and MWD significantly improved at completion of 12-weeks supervised exercise training as compared to baseline (PWD 114 ± 100 vs. 235 ± 248, p = 0.002; MWD 297 ± 273 vs. 474 ± 359, p = 0.001). Improvement of PWD and MWD could be maintained at follow up (197 ± 254, p = 0.014; 390 ± 324, p = 0.035, respectively) with non-smokers showing significantly better sustained PWD and MWD improvement as compared to baseline. Overall, walking capacity correlated with functional status of quality of life. Conclusions: Major findings of this investigation were that improvement in walking capacity is sustained after completion of supervised exercise training program with best results in patients who quitted or never smoked. Improved walking capacity is associated with increased functional status of quality of life.

scholarly journals Individualised physical activity programme in patients over 65 years with haematological malignancies (OCAPI): protocol for a single-arm feasibility trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046409
Author(s):  
Baptiste Fournier ◽  
Emmanuelle Nicolas-Virelizier ◽  
Chiara Russo ◽  
Olivia Pérol ◽  
Guillaume Y Millet ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Older Adults ◽  
Physical Function ◽  
Older Patients ◽  
Feasibility Trial ◽  
Haematological Malignancies ◽  
Physical Activity Programme ◽  
Supervised Exercise

IntroductionOlder adults with cancer suffer from the combined effects of ageing, cancer disease and treatment side effects. The main treatment for patients with haematological malignancies is chemotherapy, associated with significant toxicities. Chemotherapy can alter patients’ physical function and quality of life which are often already diminished in older patients due to ageing and comorbidities. It therefore seems essential to develop and to evaluate interventions capable of preventing physical and psychosocial decline and its consequences. Promoting physical activity is a promising approach to improve physical function and quality of life in older adults with cancer, but there are limited data on the feasibility of such interventions among older patients with haematological malignancies, concomitant to chemotherapy.Methods and analysisOCAPI (OnCogeriatric and Individualized Physical Activity) is a single-arm, interdisciplinary, prospective, interventional, feasibility study. It is intended to include 40 patients (20 patients with acute myeloid leukaemia and 20 patients with non-Hodgkin’s lymphoma) over 65 years in an individualised 6-month physical activity programme. The programme consists of individually supervised exercise sessions with an increasing volume of physical activity either at home and/or in a laminar airflow room (depending on the disease and treatment regimen) followed by unsupervised sessions and phone follow-ups. Patients will receive an activity tracker during the 6 months of the programme. Evaluations will take place at inclusion and at 3, 6 and 12 months to assess the feasibility of the programme and to explore potential changes in physical, psychosocial and clinical outcomes. The results will generate preliminary data to implement a larger randomised controlled trial.Ethics and disseminationThe study protocol was approved by the French ethics committee (Comité de protection des personnes Est I, N°ID-RCB 2019-A01231-56, 12 July 2019). All participants will have to sign and date an informed consent form. The findings will be disseminated in peer-reviewed journals and academic conferences.Trial registration numberNCT04052126.

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