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 .
Supervised exercise, stent revascularization, or medical therapy for claudication due to aortoiliac peripheral artery disease: the CLEVER study.
BACKGROUND Treatment for claudication that is due to aortoiliac peripheral artery disease ( PAD ) often relies on stent revascularization ( ST ) . However , supervised exercise ( SE ) is known to provide comparable short-term ( 6-month ) improvements in functional status and quality of life . Longer-term outcomes are not known . OBJECTIVES The goal of this study was to report the longer-term ( 18-month ) efficacy of SE compared with ST and optimal medical care ( OMC ) . METHODS Of 111 patients with aortoiliac PAD r and omly assigned to receive OMC , OMC plus SE , or OMC plus ST , 79 completed the 18-month clinical and treadmill follow-up assessment . SE consisted of 6 months of SE and an additional year of telephone-based exercise counseling . Primary clinical outcomes included objective treadmill-based walking performance and subjective quality of life . RESULTS Peak walking time improved from baseline to 18 months for both SE ( 5.0 ± 5.4 min ) and ST ( 3.2 ± 4.7 min ) significantly more than for OMC ( 0.2 ± 2.1 min ; p < 0.001 and p = 0.04 , respectively ) . The difference between SE and ST was not significant ( p = 0.16 ) . Improvement in claudication onset time was greater for SE compared with OMC , but not for ST compared with OMC . Many disease-specific quality -of-life scales demonstrated durable improvements that were greater for ST compared with SE or OMC . CONCLUSIONS Both SE and ST had better 18-month outcomes than OMC . SE and ST provided comparable durable improvement in functional status and in quality of life up to 18 months . The durability of claudication exercise interventions merits its consideration as a primary PAD claudication treatment
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 .