Article

PURPOSE: To summarize evidence regarding exercise therapy for people with lower
extremity peripheral artery disease (PAD). METHODS: Literature was reviewed
regarding optimal strategies for delivering exercise interventions for people
with PAD. Randomized trial evidence and recent studies were emphasized. RESULTS:
Randomized clinical trial evidence consistently demonstrates that supervised
treadmill exercise improves treadmill walking performance in people with PAD. A
meta-analysis of 25 randomized trials (1054 participants) concluded that
supervised treadmill exercise was associated with 180 m of improvement in maximal
treadmill walking distance and 128 m of improvement in pain-free walking distance
compared with a control group. Three randomized trials of 493 patients with PAD
demonstrated that home-based walking exercise interventions that incorporate
behavioral change techniques improve walking ability in patients with PAD.
Furthermore, evidence suggests that home-based walking exercise improves the
6-min walk more than supervised treadmill exercise. Upper and lower extremity
ergometry also significantly improved walking endurance in PAD. The Centers for
Medicare & Medicaid Services recently determined that Medicare would cover 12 wk
(36 sessions) of supervised treadmill exercise for patients with PAD.
CONCLUSIONS: Supervised treadmill exercise and home-based walking exercise each
improve walking ability in patients with PAD. The availability of insurance
coverage for supervised treadmill exercise for patients with PAD will make
supervised treadmill exercise more widely available and accessible. Home-based
exercise that incorporates behavioral change technique is an effective
alternative for patients unwilling or unable to attend 3 supervised exercise sessions per week.

Langue : ANGLAIS