[An epidemiologic study of the value and limits of physical therapy/exercise therapy in Fontaine stage II arterial...

Using a questionaire the members of the German Society for Angiology (DGA) were interrogated on the use of physical training for the treatment of peripheral arterial occlusive disease; from a total of n = 431 as much as n = 156 responded, i.e. making up a response of 36%. 104 of them conduct physical training either on their own or assign patients to it (67%). In most of the institutions exclusively walking/interval training (83%) or medical exercise (74%) are performed. In most cases the training is conducted by physiotherapeutists (71%). 13% of the patients are admitted exclusively to physical training, 34% undergo combined therapy, i.e. physical training and vaso-active medication. 22% receive mere medical, 31% surgical treatment. A general evaluation on the success of the different therapies applied turned out following frequency: 1. combined therapy (medical treatment/physical training); 2. surgical procedures as a therapeutic measure; 3. physical training; 4. medical treatment. A further study performed at three ambulatory centres offering physical training were to show what kind and to which extent such training is useful. In 34% of the cases (from a total of n = 201 patients with peripheral arterial occlusive disease in state II according to Fontaine) contraindications argue against the application of physical training. From a rest of 66% as much as 36% of the patients refuse to undergo physical training the reasons of which were stated with large transport distances and time problems. The remaining rest accepts the offer, although 24% attend such training only sporadically. The results show that mainly contraindications and insufficient patient compliance account for the fact that only one third of the patients attend physical training. The results are discussed and proposals are made to improve patient compliance.