The aim of this study was to explore the effects during 12 months follow-up of 12 weeks of supervised exercise therapy (SET) after percutaneous transluminal angioplasty (PTA) compared to PTA alone on physical function, limb hemodynamics and health-related quality of life (HRQoL) in patients with intermittent claudication. Fifty patients were randomised to an intervention or a control group. Both groups received usual post-operative care and follow-up measurements at three, six and 12 months after PTA. The intervention group performed 12 weeks of SET after PTA. The control group did not receive any additional follow-up regarding exercise. During the 12 months’ follow-up, the members of the intervention group had significantly better walking distance than the control group. The intervention group had a significantly higher HRQoL score in the physical component score of the SF-36, and the domains of physical function, bodily pain and vitality. For limb hemodynamics, there was a non-significant trend towards better results in the intervention group compared to the control group. Conclusion: SET after PTA yielded statistically significantly better results for walking distance and HRQoL in the intervention group than the control group during the 12 months of follow-up.
References
[1]
Norgren, L.; Hiatt, W.R.; Dormandy, J.A.; Nehler, M.R.; Harris, K.A.; Fowkes, F.G. Inter-society consensus for the management of peripheral arterial disease (Tasc II). J. Vasc. Surg. 2007, 45, S5–S67, doi:10.1016/j.jvs.2006.12.037.
Stroke, O.E.; Tendera, M.; Aboyans, V.; Bartelink, M.L.; Baumgartner, I.; Clement, D.; Collet, J.P.; Cremonesi, A.; de Carlo, M.; Erbel, R.; et al. Esc guidelines on the diagnosis and treatment of peripheral artery diseases. Eur. Heart J. 2011, 32, 2851–2906.
[4]
Olin, J.W.; Allie, D.E.; Belkin, M.; Bonow, R.O.; Casey, D.E., Jr.; Creager, M.A.; Gerber, T.C.; Hirsch, A.T.; Jaff, M.R.; Kaufman, J.A.; et al. Accf/aha/acr/scai/sir/svm/svn/svs 2010 performance measures for adults with peripheral artery disease. A report of the american college of cardiology foundation/american heart association task force on performance measures, the american college of radiology, the society for cardiac angiography and interventions, the society for interventional radiology, the society for vascular medicine, the society for vascular nursing, and the society for vascular surgery (writing committee to develop clinical performance measures for peripheral artery disease). Vasc. Med. 2010, 15, 481–512, doi:10.1177/1358863X10390838.
[5]
Ahimastos, A.A.; Pappas, E.P.; Buttner, P.G.; Walker, P.J.; Kingwell, B.A.; Golledge, J. A meta-analysis of the outcome of endovascular and noninvasive therapies in the treatment of intermittent claudication. J. Vasc. Surg. 2011, 54, 1511–1521.
[6]
Frans, F.A.; Bipat, S.; Reekers, J.A.; Legemate, D.A.; Koelemay, M.J. Systematic review of exercise training or percutaneous transluminal angioplasty for intermittent claudication. Br. J. Surg. 2011, 99, 16–28.
[7]
Guidon, M.; McGee, H. Exercise-based interventions and health-related quality of life in intermittent claudication: A 20-year (1989–2008) review. Eur. J. Cardiovasc. Prev. Rehabil. 2010, 17, 140–154, doi:10.1097/HJR.0b013e3283377f08.
[8]
Lauret, G.J.; van Dalen, D.C.; Willigendael, E.M.; Hendriks, E.J.; de Bie, R.A.; Spronk, S.; Teijink, J.A. Supervised exercise therapy for intermittent claudication: Current status and future perspectives. Vascular 2012, 20, 12–19, doi:10.1258/vasc.2011.ra0052.
[9]
Lauret, G.J.; Fakhry, F.; Fokkenrood, H.J.P.; Hunink, M.G.; Teijink, J.A.W.; Spronk, S. Modes of exercise training for intermittent claudication (protocol). Cochrane Database Syst. Rev. 2012, 2, doi:10.1002/14651858.CD009638.
[10]
Muller-Riemenschneider, F.; Reinhold, T.; Nocon, M.; Willich, S.N. Long-term effectiveness of interventions promoting physical activity: A systematic review. Prev. Med. 2008, 47, 354–368, doi:10.1016/j.ypmed.2008.07.006.
Kolh, P. Improving quality of life in patients with peripheral arterial disease: An important goal. Eur. J. Vasc. Endovasc. Surg. 2010, 40, 626–627, doi:10.1016/j.ejvs.2010.07.021.
[14]
Kruidenier, L.M.; Nicolai, S.P.; Rouwet, E.V.; Peters, R.J.; Prins, M.H.; Teijink, J.A. Additional supervised exercise therapy after a percutaneous vascular intervention for peripheral arterial disease: A randomized clinical trial. J. Vasc. Interven. Radiol 2011, 22, 961–968, doi:10.1016/j.jvir.2011.02.017.
[15]
Mazari, F.A.; Khan, J.A.; Carradice, D.; Samuel, N.; Rahman, M.N.A.; Gulati, S.; Lee, H.L.; Mehta, T.A.; McCollum, P.T.; Chetter, I.C. Randomized clinical trial of percutaneous transluminal angioplasty, supervised exercise and combined treatment for intermittent claudication due to femoropopliteal arterial disease. Br. J. Surg. 2011, 99, 39–48.
[16]
Schulz, K.F.; Altman, D.G.; Moher, D.; Group, C. Consort 2010 statement: Updated guidelines for reporting parallel group randomised trials. BMJ 2010, 340, doi:10.1186/1741-7015-8-18.
[17]
Perera, S.; Mody, S.H.; Woodman, R.C.; Studenski, S.A. Meaningful change and responsiveness in common physical performance measures in older adults. J. Amer. Geriat. Soc. 2006, 54, 743–749, doi:10.1111/j.1532-5415.2006.00701.x.
[18]
Nilsson, B.B.; Hellesnes, B.; Westheim, A.; Risberg, M.A. Group-based aerobic interval training in patients with chronic heart failure: Norwegian ullevaal model. Phys. Ther. 2008, 88, 523–535, doi:10.2522/ptj.20060374.
[19]
Borg, G.A. Psychophysical bases of perceived exertion. Med. Sci. Sport. Exercise 1982, 14, 377–381.
[20]
Guyatt, G.H.; Sullivan, M.J.; Thompson, P.J.; Fallen, E.L.; Pugsley, S.O.; Taylor, D.W.; Berman, L.B. The 6-minute walk: A new measure of exercise capacity in patients with chronic heart failure. Can. Med. Assn. J. 1985, 132, 919–923.
[21]
McDermott, M.M.; Ades, P.A.; Dyer, A.; Guralnik, J.M.; Kibbe, M.; Criqui, M.H. Corridor-based functional performance measures correlate better with physical activity during daily life than treadmill measures in persons with peripheral arterial disease. J. Vasc. Surg. 2008, 48, 1231–1237, doi:10.1016/j.jvs.2008.06.050.
[22]
Montgomery, P.S.; Gardner, A.W. The clinical utility of a six-minute walk test in peripheral arterial occlusive disease patients. J. Amer. Geriat. Soc. 1998, 46, 706–711.
[23]
Gardner, A.W.; Skinner, J.S.; Cantwell, B.W.; Smith, L.K. Progressive vs single-stage treadmill tests for evaluation of claudication. Med. Sci Sport Exercise 1991, 23, 402–408.
[24]
Hiatt, W.R.; Hirsch, A.T.; Regensteiner, J.G.; Brass, E.P. Clinical trials for claudication. Assessment of exercise performance, functional status, and clinical end points. Vascular clinical trialists. Circulation 1995, 92, 614–621, doi:10.1161/01.CIR.92.3.614.
[25]
Nicolai, S.P.; Viechtbauer, W.; Kruidenier, L.M.; Candel, M.J.; Prins, M.H.; Teijink, J.A. Reliability of treadmill testing in peripheral arterial disease: A meta-regression analysis. J. Vasc. Surg. 2009, 50, 322–329, doi:10.1016/j.jvs.2009.01.042.
[26]
Ware, J.E., Jr.; Sherbourne, C.D. The mos 36-item short-form health survey (sf-36). I. Conceptual framework and item selection. Med. Care 1992, 30, 473–483, doi:10.1097/00005650-199206000-00002.
[27]
Spengel, F.A.; Brown, T.M.; Dietze, S.; Kirchberger, I.; Comte, S. The claudication scale (Clau-s). A new disease-specific quality-of-life instrument in intermittent claudication. Dis. Manag. Health Outcomes 1997, 2, 65–70.
[28]
Beattie, D.K.; Golledge, J.; Greenhalgh, R.M.; Davies, A.H. Quality of life assessment in vascular disease: Towards a consensus. Eur. J. Vasc. Endovasc. Surg. 1997, 13, 9–13, doi:10.1016/S1078-5884(97)80044-5.
[29]
Chetter, I.C.; Scott, D.J.; Kester, R.C. An introduction to quality of life analysis: The new outcome measure in vascular surgery. Eur. J. Vasc. Endovasc. Surg. 1998, 15, 4–6, doi:10.1016/S1078-5884(98)80065-8.
[30]
Mehta, T.; Subramaniam, A.V.; Chetter, I.; McCollum, P. Assessing the validity and responsiveness of disease-specific quality of life instruments in intermittent claudication. Eur. J. Vasc. Endovasc. Surg. 2006, 31, 46–52, doi:10.1016/j.ejvs.2005.08.028.
[31]
McHorney, C.A.; Tarlov, A.R. Individual-patient monitoring in clinical practice: Are available health status surveys adequate? Qual. Life Res. 1995, 4, 293–307, doi:10.1007/BF01593882.
[32]
B?, E.; Hisdal, J.; Stranden, E.; J?rgensen, J.J.; Sandbaek, G.; Gr?tta, O.J.; Bergland, A. Effects of 12 weeks of supervised exercise after endovascular treatment: A randomised clinical trial. Phys. Res. Int. 2013. resubmitted.
[33]
Gardner, A.W.; Katzel, L.I.; Sorkin, J.D.; Bradham, D.D.; Hochberg, M.C.; Flinn, W.R.; Goldberg, A.P. Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: A randomized controlled trial. J. Amer. Geriat. Soc. 2001, 49, 755–762, doi:10.1046/j.1532-5415.2001.49152.x.
[34]
Tsai, J.C.; Chan, P.; Wang, C.H.; Jeng, C.; Hsieh, M.H.; Kao, P.F.; Chen, Y.J.; Liu, J.C. The effects of exercise training on walking function and perception of health status in elderly patients with peripheral arterial occlusive disease. J. Intern. med. 2002, 252, 448–455, doi:10.1046/j.1365-2796.2002.01055.x.
[35]
Galea, M.N.; Weinman, J.A.; White, C.; Bearne, L.M. Do behaviour-change techniques contribute to the effectiveness of exercise therapy in patients with intermittent claudication? A systematic review. Eur. J. Vasc. Endovasc. Surg , 1, 132–141.
[36]
Garber, C.E.; Blissmer, B.; Deschenes, M.R.; Franklin, B.A.; Lamonte, M.J.; Lee, I.M.; Nieman, D.C.; Swain, D.P. American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Med. Sci. Sport. Exercise 2011, 43, 1334–1359, doi:10.1249/MSS.0b013e318213fefb.