Effects of 12 Weeks of Supervised Exercise After Endovascular Treatment: A Randomized Clinical Trial

Elisabeth Bø; Astrid Bergland; Einar Stranden; Jørgen J Jørgensen; Gunnar Sandbaek; Ole Jørgen Grøtta; Jonny Hisdal

doi:10.1002/pri.1608

Effects of 12 Weeks of Supervised Exercise After Endovascular Treatment: A Randomized Clinical Trial

Physiother Res Int. 2015 Sep;20(3):147-57. doi: 10.1002/pri.1608. Epub 2014 Dec 2.

Authors

Elisabeth Bø^{1

2

3}, Astrid Bergland¹, Einar Stranden^{2

4}, Jørgen J Jørgensen^{2

5}, Gunnar Sandbaek^{2

6}, Ole Jørgen Grøtta⁶, Jonny Hisdal⁴

Affiliations

¹ Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
² Faculty of Medicine, University of Oslo, Oslo, Norway.
³ Oslo University Hospital Aker, Oslo, Norway.
⁴ Section of Vascular Investigations, Oslo Vascular Centre, Oslo University Hospital Aker, Oslo, Norway.
⁵ Oslo Vascular Centre, Oslo University Hospital Aker, Oslo, Norway.
⁶ Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.

PMID: 25451336
DOI: 10.1002/pri.1608

Abstract

Background and purpose: This study aimed to assess the effects of supervised exercise training (SET) after percutaneous transluminal angioplasty (PTA) compared with PTA alone on physical function, limb hemodynamics and health-related quality of life in patients with intermittent claudication.

Methods: Fifty patients who all underwent PTA for intermittent claudication were included in the study. Both groups received usual post-operative care. In addition, the intervention group performed two sessions of hospital-based SET and one home-based exercise session per week for 12 weeks after PTA. The control group did not receive any additional follow-up regarding exercise. The primary outcome was the result of a standardized 6-minute walk test. Secondary outcomes were the treadmill maximum walking distance, treadmill pain-free walking distance, ankle-brachial index, pulse volume recording on the leg and ultrasound scanning. Health-related quality of life was measured using the Short Form 36 and the Claudication Scale.

Results: All measures, except for the Short Form 36 domain of mental health, showed statistically significant positive changes from baseline to 3 months for both groups (p < 0.05). At 3 months, there was a trend towards better results for the intervention group compared with the control group. The median improvement from baseline to 3 months for the 6-minute walk test was 66 m for the intervention group and 45 m for the control group. For maximum walking distance, the median improvement was 251 m for the intervention group and 93 m for the control group.

Discussion: Supervised exercise training after endovascular treatment for patients with intermittent claudication led to greater positive changes after 3 months in the intervention group compared with the control group. The present study's trends of better results with SET after PTA add to the emerging existing evidence, which should encourage physiotherapy practice to offer SET for this patient group.

Keywords: endovascular procedures; exercise; intermittent claudication.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Aged
Aged, 80 and over
Endovascular Procedures / adverse effects
Endovascular Procedures / methods*
Exercise Therapy / methods*
Exercise Tolerance / physiology*
Female
Follow-Up Studies
Humans
Intermittent Claudication / diagnostic imaging
Intermittent Claudication / rehabilitation*
Intermittent Claudication / therapy
Male
Middle Aged
Norway
Pain Measurement
Peripheral Arterial Disease / diagnostic imaging
Peripheral Arterial Disease / rehabilitation*
Peripheral Arterial Disease / therapy
Postoperative Care / methods
Regional Blood Flow / physiology
Risk Assessment
Severity of Illness Index
Single-Blind Method
Statistics, Nonparametric
Time Factors
Treatment Outcome
Ultrasonography, Doppler
Walking / physiology*