[Physical trainings in peripheral atherosclerosis: problems and ways of solution]

Area of Science:

• Vascular Medicine
• Rehabilitation Science

Context:

• Peripheral atherosclerosis (PA) significantly impacts quality of life and prognosis.
• Current guidelines strongly recommend physical training (PT) for intermittent claudication (Class I, Level A evidence).
• A significant gap exists between the proven efficacy of PT and patient adherence to programs.

Purpose:

• To review subjective and objective factors limiting patient participation in PT for PA.
• To explore novel approaches for improving adherence and outcomes in PA patients undergoing PT.

Summary:

• Despite strong evidence, few PA patients adhere to recommended physical training programs due to various limiting factors.
• Proposed solutions include low-intensity exercise, training of multiple muscle groups, integral training, and skeletal muscle electrostimulation.
• Early intervention in subclinical PA and behavioral therapy are also discussed, suggesting a need for specialized neurosurgical involvement.

Impact:

• Improved patient adherence to physical training can enhance quality of life and prognosis for individuals with peripheral atherosclerosis.
• Novel training strategies and early detection/rehabilitation may reduce the burden of PA.
• New organizational models involving specialists like neurosurgeons are needed for effective PA management.