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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Peripheral Artery Disease IV: Nursing Management01:26

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Peripheral Artery Disease I: Introduction01:30

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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Atherosclerosis III: Management01:26

Atherosclerosis III: Management

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Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
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Adherence and exercise mode in supervised exercise therapy for peripheral artery disease.

Kristin M Elgersma1, Rebecca J L Brown1, Dereck L Salisbury1

  • 1University of Minnesota, School of Nursing, Minneapolis, Minnesota.

Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing
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PubMed
Summary

A multimodal approach to supervised exercise therapy (SET) for peripheral artery disease (PAD) improved patient adherence and exercise capacity compared to treadmill exercise alone. Recumbent total body stepping (step-ex) proved safe and effective within a multimodal PAD exercise program.

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Area of Science:

  • Cardiovascular Medicine
  • Exercise Physiology
  • Rehabilitation Science

Background:

  • Supervised exercise therapy (SET) is a primary treatment for peripheral artery disease (PAD).
  • Limited data exist on patient adherence to SET programs.
  • Recumbent total body stepping (step-ex) has not been previously studied in PAD patients.

Purpose of the Study:

  • To compare adherence to a 12-week SET program across different exercise modes: treadmill walking, step-ex, and a multimodal approach.
  • To evaluate the safety and viability of step-ex for PAD patients by assessing changes in exercise training capacity.
  • To determine if exercise mode impacts adherence and improvements in exercise capacity in PAD patients.

Main Methods:

  • Fifty-three PAD patients (mean age 74.2 years, 50% female) were randomized into three groups: treadmill walking (n=17), step-ex (n=18), or multimodal (n=18).
  • Adherence to the 12-week SET program was monitored.
  • Exercise training capacity was measured by the highest metabolic equivalent of tasks (METs) achieved and total MET-minutes per session.

Main Results:

  • Overall adherence to SET was 62%, with significant differences between groups (P=.022).
  • The multimodal group demonstrated higher adherence (73.6%) compared to the treadmill group (50.2%) (P=.010).
  • All groups improved exercise training capacity, but the multimodal group showed greater improvement in total MET-minutes achieved per session (61.5) versus the treadmill group (14.7) (P=.008).

Conclusions:

  • A multimodal exercise approach for PAD patients leads to superior adherence and enhanced exercise training capacity.
  • Recumbent total body stepping (step-ex) is a safe and viable option for PAD patients within SET programs.
  • Consideration of multimodal SET incorporating step-ex is recommended for the diverse PAD population.