Supervised exercise therapy for intermittent claudication: current status and future perspectives.

Abstract:

:Intermittent claudication (IC) has a high prevalence in the older population and is closely associated with cardiovascular and cerebrovascular disease. High mortality rates are reported due to ongoing atherosclerotic disease. Because of these serious health risks, treatment of IC should address reduction of cardiovascular events (and related morbidity/mortality) and improvement of the poor health-related quality of life (QoL) and functional capacity. In several randomized clinical trials and systematic reviews, supervised exercise therapy (SET) is compared with non-supervised exercise, usual care, placebo, walking advice or vascular interventions. The current evidence supports SET as the primary treatment for IC. SET improves maximum walking distance and health-related QoL with a marginal risk of co-morbidity or mortality. This is also illustrated in contemporary international guidelines. Community-based SET appears to be at least as efficacious as programs provided in a clinical setting. In the Netherlands, a national integrated care network (ClaudicatioNet) providing specialized care for patients with IC is currently being implemented. Besides providing a standardized form of SET, the specialized physical therapists stimulate medication compliance and perform lifestyle coaching. Future research should focus on the influence of co-morbidities on prognosis and effect of SET outcome and the potential beneficial effects of SET combined with a vascular intervention.

journal_name

Vascular

journal_title

Vascular

authors

Lauret GJ,van Dalen DC,Willigendael EM,Hendriks EJ,de Bie RA,Spronk S,Teijink JA

doi

10.1258/vasc.2011.ra0052

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

12-9

issue

1

eissn

1708-5381

issn

1708-539X

pii

vasc.2011.ra0052

journal_volume

20

pub_type

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