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Adherence to Supervised and Unsupervised Exercise Programmes in Ageing Population with Intermittent Claudication: A

Cecilia Herrero-Alonso1,2,3, Victor-Miguel López-Lifante1,2,3,4, Anna Costa-Garrido1

  • 1Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08303 Mataro, Spain.

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Standard advice from healthcare professionals improved adherence to exercise programs for individuals with intermittent claudication (IC). Supervised exercise interventions showed lower adherence compared to standard advice.

Keywords:
adherenceclinical trialintermittent claudicationmedical education and trainingprimary health caresports medicinevascular medicine

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Area of Science:

  • Cardiovascular Medicine
  • Exercise Physiology

Background:

  • Intermittent claudication symptomatic peripheral arterial disease (ICSPAD) significantly impairs mobility and quality of life.
  • Physical exercise is a key non-pharmacological treatment for ICSPAD.
  • Adherence to exercise programs is a significant challenge in ICSPAD management due to disease complexity and comorbidities.

Purpose of the Study:

  • To evaluate adherence rates across four distinct exercise programs for ICSPAD patients.
  • To compare adherence between supervised (walking, strength, concurrent) and unsupervised (standard advice) interventions.

Main Methods:

  • A clinical trial involving 122 ICSPAD patients randomized into four groups: standard advice, walking, strength, and concurrent exercise.
  • Adherence to prescribed exercise and pedometer use was monitored.
  • Logistic regression analysis was used to identify factors influencing adherence.

Main Results:

  • Adherence was highest in the standard advice group compared to all supervised intervention groups.
  • Younger age was noted in the strength intervention group; higher hypertension prevalence in the walking group.
  • No significant adherence differences were found based on ankle-brachial index or IC severity, although mild cases showed a trend towards higher adherence.

Conclusions:

  • Standard advice from healthcare professionals is a significant positive predictor of treatment adherence in ICSPAD.
  • Supervised exercise interventions may face greater adherence challenges compared to standard advice protocols.