Additional supervised exercise therapy after a percutaneous vascular intervention for peripheral arterial disease: a randomized clinical trial.

Abstract

PURPOSE:

To determine whether a percutaneous vascular intervention (PVI) combined with supplemental supervised exercise therapy (SET) is more effective than a PVI alone in improving walking ability in patients with symptomatic peripheral arterial disease (PAD).

MATERIALS AND METHODS:

In this prospective randomized trial, patients with PAD treated with a PVI were eligible. Exclusion criteria were major amputation or tissue loss, comorbidity preventing physical activity, insufficient knowledge of the Dutch language, no insurance for SET, and prior participation in a SET program. All patients received a PVI and subsequently were randomly assigned to either the PVI alone group (n = 35) or the PVI + SET group (n = 35). The primary outcome parameter was the absolute claudication distance (ACD). This trial was registered at Clinical trials.gov, NCT00497445.

RESULTS:

The study included 70 patients, most of whom were treated for an aortoiliac lesion. The mean difference in ACD at 6 months of follow-up was 271.3 m (95% confidence interval [CI] 64.0-478.6, P = .011) in favor of additional SET. In the PVI alone group, 1 (3.7%) patient finished the complete treadmill test compared with 11 (32.4%) patients in the PVI + SET group (P = .005). Physical health-related quality-of-life score was 44.1 ± 7.8 in the PVI alone group compared with 41.9 ± 9.5 in the PVI + SET group, which was a nonsignificant difference (P = .34).

CONCLUSIONS:

SET following a PVI is more effective in increasing walking distance compared with a PVI alone. These data indicate that SET is a useful adjunct to a PVI for the treatment of PAD.

• Authors: Lotte M Kruidenier, Saskia P Nicolaï, Ellen V Rouwet, Ron J Peters, Martin H Prins, Joep A W Teijink
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 22 Issue 7 Pg. 961-8 (Jul 2011) ISSN: 1535-7732 [Electronic] United States
• PMID: 21571547 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Ankle Brachial Index
• Chi-Square Distribution
• Combined Modality Therapy
• Endovascular Procedures
• Exercise Test
• Exercise Therapy
• Female
• Hemodynamics
• Humans
• Intermittent Claudication (etiology, physiopathology, therapy)
• Male
• Middle Aged
• Netherlands
• Peripheral Arterial Disease (complications, physiopathology, therapy)
• Prospective Studies
• Quality of Life
• Recovery of Function
• Regression Analysis
• Surveys and Questionnaires
• Time Factors
• Treatment Outcome
• Walking