Community trial of home-based exercise therapy for intermittent claudication

Area of Science:

• Vascular Medicine
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Peripheral arterial disease (PAD) affects many individuals, with intermittent claudication (IC) significantly impacting quality of life.
• Supervised exercise therapy is effective for IC but often lacks insurance reimbursement, leading to the prevalence of non-supervised programs.
• Evidence for the efficacy of non-supervised exercise programs for IC remains limited.

Purpose of the Study:

• To evaluate the outcomes of a structured 6-month home-based exercise program for patients with PAD and IC.
• To identify patient factors associated with program completion and benefit.

Main Methods:

• Retrospective analysis of routine care data from 120 patients with PAD and IC enrolled in a home-based exercise program.
• Assessment of claudication distances (initial and absolute) and program completion rates.
• Analysis of patient factors influencing completion and outcomes.

Main Results:

• A 34.2% completion rate was observed among 120 enrolled patients.
• Completers showed significant improvements: 86.4% in initial claudication distance and 19.8% in absolute claudication distance.
• No specific patient factors predicted program completion; 47% of non-completers missed follow-up appointments.

Conclusions:

• Home-based exercise programs can yield improvements in IC symptoms for PAD patients, though less pronounced than supervised programs.
• Low adherence and missed follow-up appointments are significant barriers to program completion.
• Future home-based IC programs require strategies to enhance patient compliance and follow-up attendance.