Availability of Supervised Exercise Programs and the Role of Structured Home-based Exercise in Peripheral Arterial Disease

Abstract Objectives The effectiveness of supervised exercise programs (SEPs) for the management of peripheral arterial disease (PAD) can be hampered by low accessibility and poor compliance. The current international availability and use of SEPs was evaluated and the evidence on alternative approach...

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Bibliographic Details
Published in:European journal of vascular and endovascular surgery 2012-12, Vol.44 (6), p.569-575
Main Authors: Makris, G.C, Lattimer, C.R, Lavida, A, Geroulakos, G
Format: Article
Language:English
Subjects:
Claudication
Europe
Evidence-Based Medicine
Exercise programs
Exercise Therapy
Guideline Adherence
Health Care Surveys
Health Services Accessibility
Home Care Services
Humans
Internet
Peripheral arterial disease
Peripheral Arterial Disease - physiopathology
Peripheral Arterial Disease - therapy
Practice Guidelines as Topic
Quality of Life
Recovery of Function
Surgery
Surveys and Questionnaires
Time Factors
Treatment Outcome
Walking
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Summary:Abstract Objectives The effectiveness of supervised exercise programs (SEPs) for the management of peripheral arterial disease (PAD) can be hampered by low accessibility and poor compliance. The current international availability and use of SEPs was evaluated and the evidence on alternative approaches such as structured, home-based exercise programs (HEPs) was reviewed. Methods-materials International survey on SEP availability among vascular surgeons using an online questionnaire. A systematic review on structured-HEPs effectiveness was also performed. Results A total of 378 responses were collected from 43 countries, with the majority (95%) from Europe. Only 30.4% of the participants had access to SEPs and within this group there was significant heterogeneity on the way SEPs were implemented. This systematic review identified 12 studies on the effectiveness of HEPs. In 3 studies SEPs were superior to HEPs in improving functional capacity or equivalent in improving quality of life (QoL). HEPs significantly improved most of the functional capacity and QoL markers when compared to the “go home and walk” advice and baseline measurements. Conclusions SEPs remain an underutilized tool despite recommendations. Structured HEPs may be effective and can be useful alternatives when SEPs are not available. Further research is warranted to establish cost-effectiveness.
ISSN:1078-5884
1532-2165
DOI:10.1016/j.ejvs.2012.09.009