In claudication patients , SE is more effective than UE at improving maximal walking and claudication distances , yet there is no difference in general quality of life or patient-reported community-based walking .
BACKGROUND Supervised exercise ( SE ) is widely accepted as an effective therapy for intermittent claudication ( IC ) , but its use is limited by cost .
Unsupervised exercise ( UE ) represents a less costly alternative .
We assessed the comparative effectiveness of SE vs UE in patients with IC .
Comparison of generic and disease-specific questionnaires for the assessment of quality of life in patients with peripheral arterial disease.
OBJECTIVE This study compared the ability of generic and disease-specific question naires to assess quality of life ( QOL ) at baseline and to detect change in QOL after treatment in patients with peripheral arterial disease ( PAD ) . METHODS This prospect i ve multicenter trial recruited 514 patients with PAD who needed an imaging workup and had an ankle brachial pressure index of less than 0.90 . Patients with severe comorbidity were excluded , leaving a study population of 450 patients . Patients completed two generic question naires , the Short Form 36 ( SF-36 ) and the European Quality of Life 5D ( EuroQol-5D ) , and one disease-specific question naire , the Vascular Quality of Life ( VascuQol ) at baseline and after 6 months of follow-up . Rutherford classification and treadmill walking distance were determined at baseline and after 6 months of follow-up and were considered indicators of disease severity . Receiver operating characteristic ( ROC ) curves and areas under the curves ( AUCs ) were used to evaluate each of the three question naires for its ability to discriminate between severe and mild disease at baseline and to discriminate between a large and small change in disease severity after follow-up . The underlying assumption was that disease severity is a major determinant of QOL . This implies that the validity of a QOL question naire is reflected by its ability to discriminate between mildly and severely diseased patients . RESULTS At baseline , 443 patients and after follow-up , 386 patients completed question naires . At baseline , no significant ( P > .05 ) differences were observed among AUCs for the total scores of the three question naires , indicating that all three question naires assessed the disease severity equally well . After follow-up , the AUCs for the VascuQol were significantly higher than the AUCs for the SF-36 and EuroQol-5D with respect to detection of improvement in Rutherford classification ( P < .05 ) , indicating that change in disease severity after follow-up was best detected by the VascuQol . CONCLUSION The VascuQol is the preferred question naire as outcome measure for QOL in future trials and clinical follow-up of patients with PAD
In claudication patients , SE is more effective than UE at improving maximal walking and claudication distances , yet there is no difference in general quality of life or patient-reported community-based walking .
BACKGROUND Supervised exercise ( SE ) is widely accepted as an effective therapy for intermittent claudication ( IC ) , but its use is limited by cost .
Unsupervised exercise ( UE ) represents a less costly alternative .
We assessed the comparative effectiveness of SE vs UE in patients with IC .