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Supervised exercise therapy: it does work, but how to set up a program?

David Hageman^1,2,3, Marijn M van den Houten^1,2,3, Steffie Spruijt³

¹Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.

The Journal of Cardiovascular Surgery

|December 22, 2016

Summary

This summary is machine-generated.

Supervised exercise therapy (SET) is the recommended first-line treatment for intermittent claudication (IC). Despite robust evidence, its implementation is limited, but a national network improved care quality.

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Area of Science:

Vascular Medicine
Rehabilitation Medicine
Public Health

Background:

Intermittent claudication (IC) is a common symptom of peripheral arterial disease, particularly in older, multimorbid patients.
IC significantly impacts functional capacity and quality of life (QoL), often co-existing with other atherosclerotic conditions.
Current treatment guidelines emphasize supervised exercise therapy (SET) as the primary intervention.

Purpose of the Study:

To evaluate the efficacy and implementation challenges of SET for IC.
To highlight the benefits of SET in improving walking distance and QoL.
To introduce ClaudicatioNet as a model for optimizing IC care.

Main Methods:

Systematic reviews and randomized controlled trials comparing SET to usual care, placebo, walking advice, and revascularization.
Analysis of barriers to SET implementation, including physician awareness and financial incentives.
Case study of the ClaudicatioNet integrated care network in the Netherlands.

Main Results:

SET demonstrates robust efficacy in alleviating IC symptoms, improving walking distance, and enhancing health-related QoL.
SET is considered the most cost-effective treatment for IC.
Despite proven benefits, global uptake of structured SET programs remains low due to implementation barriers.

Conclusions:

SET is a safe, efficient, and cost-effective first-line treatment for intermittent claudication.
Barriers to SET implementation include physician knowledge gaps, financial disincentives, and lack of standardized networks.
The ClaudicatioNet initiative in the Netherlands successfully improved the quality of care for IC patients through integrated network development.