The HBET group did not show improvement in MWD/T compared with the WA group ( SMD 0.30 , 95 % CI -0.45 to 1.05 ; P = 0.43 ; moderate- quality evidence ) .Compared with HBET , SET was more beneficial for PFWD/T but had no effect on quality of life parameters nor on self-reported functional impairment .
Compared with WA , SET was more beneficial for PFWD/T and self-reported functional impairment , as well as for some quality of life parameters ( e.g. , physical functioning , pain , and physical component summary after 12 months ) , and HBET had no effect .
Data show no obvious effects on mortality rates .
Evidence of moderate and high quality shows that SET provides an important benefit for treadmill-measured walking distance ( MWD and PFWD ) compared with HBET and WA , respectively .
Although its clinical relevance has not been definitively demonstrated , this benefit translates to increased MWD of 120 and 210 meters after three months in SET groups .
These increased walking distances are likely to have a positive impact on the lives of patients with IC .
Data provide no clear evidence of a difference between HBET and WA .
Trials show no clear differences in quality of life parameters nor in self-reported functional impairment between SET and HBET .
BACKGROUND Although supervised exercise therapy ( SET ) provides significant symptomatic benefit for patients with intermittent claudication ( IC ) , it remains an underutilized tool .
Widespread implementation of SET is restricted by lack of facilities and funding .
Structured home-based exercise therapy ( HBET ) with an observation component ( e.g. , exercise logbooks , pedometers ) and just walking advice ( WA ) are alternatives to SET .
This is the second up date of a review first published in 2006 .
OBJECTIVES The primary objective was to provide an accurate overview of studies evaluating effects of SET programs , HBET programs , and WA on maximal treadmill walking distance or time ( MWD/T ) for patients with IC .
Secondary objectives were to evaluate effects of SET , HBET , and WA on pain-free treadmill walking distance or time ( PFWD/T ) , quality of life , and self-reported functional impairment .
Evaluation of 6- and 12-month supervised exercise training on strength and endurance parameters in patients with peripheral arterial disease
Summary Background The classic symptom of peripheral arterial disease is the intermittent claudication ( IC ) . Generally , endurance training is recommended to improve patients ’ walking performance . A potential benefit of the combination with strength training and the optimal duration of such an exercise program remain unclear . Methods and results We evaluated the effects of a supervised exercise program combining endurance and strength training lasting 6 or 12 months in patients with IC . A total of 94 patients joined this study ; 42 completed the 6-month training program ( group A ) , whereas 52 patients completed the 12-month protocol ( group B ) . Both groups exhibited a significant increase in all parameters evaluated , but greater benefit was found in the 12-month training group . The absolute claudication distance increased similarly by 27.5 and 29.5 % , respectively , in both groups ( not significant ) ; however , group B exhibited a greater increase in walking speed ( 12.1 vs. 5.3 % , p < 0.001 ) . All strength parameters increased significantly in both the groups showing an increase for “ pushing ” by 90.0 % ( group A ) and 90.2 % ( group B ) , for “ pulling ” by 64.2 % ( group A ) and 75.3 % ( group B ) , and for “ tiptoe st and ing ” by 70.5 % ( group A ) and 113.7 % ( group B ; p < 0.05 ) . Conclusion The results of this study indicate that a combined exercise program significantly increases walking speed , absolute claudication distance , and muscle strength parameters . A greater benefit seems to result from a 12-month training program . ZusammenfassungHintergrundDas klassische Symptom der peripheren arteriellen Verschlusskrankheit ist die Claudicatio intermittens ( CI ) . I m Allgemeinen wird ein Ausdauertraining empfohlen , um die Gehleistung der Patienten zu verbessern . Ein möglicher Nutzen einer Kombination mit Krafttraining und die optimale Dauer solcher Trainingsprogramme sind aber unklar . Method en und ErgebnisseWir evaluierten den Effekt eines sechs beziehungsweise 12 Monate dauernden überwachten Trainingsprogrammes , in dem Kraft- und Ausdauertraining kombiniert waren , auf Patienten mit CI . 94 Patienten nahmen an dieser Studie teil , 42 absolvierten das 6-Monate-Trainingsprogramm ( Gruppe A ) , 52 das 12-Monate-Trainingsprogramm ( Gruppe B ) . In beiden Gruppen zeigte sich ein signifikanter Anstieg in den evaluierten Parametern , wobei ein größerer Nutzen in der 12-Monats-Gruppe gefunden wurde . Die absolute Claudicatio-Strecke stieg gleichermaßen um 27,5 % beziehungsweisen 29,5 % in beiden Gruppen ( n.s . ) , wobei Gruppe B einen größeren Anstieg in der Gehgeschwindigkeit aufwies ( 12,1 % vs. 5,3 % , p < 0,001 ) . Alle Kraftparameter stiegen signifikant in beiden Gruppen an und zeigten einen Anstieg beim „ Drücken “ um 90,0 % ( Gruppe A ) beziehungsweise 90,2 % ( Gruppe B ) , für „ Ziehen “ 64,2 % beziehungsweise 75,3 % und bei den „ Zehenspitzenständen “ um 70,5 % beziehungsweise 113,7 % ( A vs. B , p < 0,05).SchlussfolgerungDie Ergebnisse dieser Studie zeigen , dass die Kombination von Kraft- und Ausdauertraining signifikant die Gehgeschwindigkeit , die absolute Claudicatio-Strecke und die Kraft-Parameter erhöhen . Das 12-Monate-Trainingsprogramm scheint dabei einen größeren Nutzen zu erzielen
The HBET group did not show improvement in MWD/T compared with the WA group ( SMD 0.30 , 95 % CI -0.45 to 1.05 ; P = 0.43 ; moderate- quality evidence ) .Compared with HBET , SET was more beneficial for PFWD/T but had no effect on quality of life parameters nor on self-reported functional impairment .
Compared with WA , SET was more beneficial for PFWD/T and self-reported functional impairment , as well as for some quality of life parameters ( e.g. , physical functioning , pain , and physical component summary after 12 months ) , and HBET had no effect .
Data show no obvious effects on mortality rates .
Evidence of moderate and high quality shows that SET provides an important benefit for treadmill-measured walking distance ( MWD and PFWD ) compared with HBET and WA , respectively .
Although its clinical relevance has not been definitively demonstrated , this benefit translates to increased MWD of 120 and 210 meters after three months in SET groups .
These increased walking distances are likely to have a positive impact on the lives of patients with IC .
Data provide no clear evidence of a difference between HBET and WA .
Trials show no clear differences in quality of life parameters nor in self-reported functional impairment between SET and HBET .
BACKGROUND Although supervised exercise therapy ( SET ) provides significant symptomatic benefit for patients with intermittent claudication ( IC ) , it remains an underutilized tool .
Widespread implementation of SET is restricted by lack of facilities and funding .
Structured home-based exercise therapy ( HBET ) with an observation component ( e.g. , exercise logbooks , pedometers ) and just walking advice ( WA ) are alternatives to SET .
This is the second up date of a review first published in 2006 .
OBJECTIVES The primary objective was to provide an accurate overview of studies evaluating effects of SET programs , HBET programs , and WA on maximal treadmill walking distance or time ( MWD/T ) for patients with IC .
Secondary objectives were to evaluate effects of SET , HBET , and WA on pain-free treadmill walking distance or time ( PFWD/T ) , quality of life , and self-reported functional impairment .