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Computerized Dynamic Posturography for Postural Control Assessment in Patients with Intermittent Claudication
Published on: December 11, 2013
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Multimodal Prehabilitation for Peripheral Arterial Disease Patients with Intermittent Claudication-A Pilot Randomized
Miquel Coca-Martinez1, Elie Girsowicz2, Robert J Doonan3
1Division of Vascular Surgery, Department of Surgery, McGill University, Montreal, Quebec, Canada; Department of Anesthesia and Intensive Care, Universitat de Barcelona, Barcelona, Spain; Department of Anesthesia, McGill University, Montreal, Quebec, Canada.
Annals of Vascular Surgery
|November 10, 2023
Summary
Multimodal prehabilitation (MP) is safe and feasible for patients with intermittent claudication, improving walking capacity and quality of life. Further trials are needed to confirm its effectiveness in reducing the need for endovascular revascularization (ER).
Area of Science:
- Vascular Surgery
- Rehabilitation Medicine
- Clinical Trials
Background:
- Intermittent claudication significantly impacts patient quality of life and functional capacity.
- Endovascular revascularization (ER) is a common treatment, but prehabilitation may offer an alternative or complementary approach.
- Pilot data are needed to assess the feasibility, safety, and preliminary efficacy of multimodal prehabilitation (MP).
Purpose of the Study:
- To establish the feasibility and safety of a 12-week multimodal prehabilitation (MP) program.
- To obtain pilot data on changes in quality of life and functional walking capacity.
- To explore the impact of MP on the decision to undergo endovascular revascularization (ER).
Main Methods:
- Pilot randomized controlled trial comparing 12-week MP to standard care (unsupervised walking advice) in patients over 50 with moderate-to-severe intermittent claudication.
- MP included supervised exercise, home exercise, nutritional support, smoking cessation, and psychosocial support.
- Feasibility assessed by recruitment/retention rates; safety by adverse events; efficacy by changes in 6-minute walk test and quality of life scores.
Main Results:
- Recruitment and retention rates were 73% and 92%, respectively, with high adherence to MP components (70-90%).
- The MP group showed statistically significant improvements in functional capacity (6-minute walk test) and quality of life (VascuQol) compared to standard care.
- No adverse events were reported; main barriers to adherence included pain and difficulty with prescribed exercises.
Conclusions:
- Multimodal prehabilitation (MP) is a safe and feasible intervention for patients with intermittent claudication.
- A 12-week MP program shows promise in improving functional walking capacity and quality of life.
- Larger trials are warranted to confirm MP's effectiveness and its impact on ER rates and long-term outcomes.
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