Effectiveness of a short duration program combining supervised exercises, nutritional advice and therapeutic...

Supervised exercise training (SET) for at least 3months is a cornerstone in the management of lower extremity peripheral artery disease (PAD). However, optimal duration of SET is discussed. This study aimed to evaluate the effectiveness of a short-duration program combining SET, nutritional advice and therapeutic education on maximal walking distance (MWD). Secondary objectives included assessing the impact of this program on smoking cessation, low-density lipoprotein cholesterol (LDL-c) levels, optimization of medical therapy, and to identify factors associated with MWD improvement.

We conducted a retrospective, monocentric study. Parameters assessed before and after the program included ankle-brachial index (ABI) at rest, MWD on treadmill, post-exercise ABI, and exercise transcutaneous oxygen pressure (TcPO2) using the Decrease from Rest of Oxygen Pressure (DROP). LDL-c levels, smoking status, and medical therapy were documented before and after the program.

Forty-three patients (77% men, median age 67 [57-74]years) were included. The median program duration was 23.5 days [20.8-30.5], with 20.7h [16.8-25.1] of supervised physical activity. MWD increased significantly from 208m [139-294] to 251m [171-574] (P<0.001). Improvements in smoking status, LDL-c levels, and medical treatment optimization were also observed. Among all parameters, only the DROP TcPO2 before the program was significantly associated with MWD improvement (P<0.05).

A short-duration program effectively improved median MWD (+56% [10-159%]), cardiovascular risk management, and was associated with baseline ischemia severity. These findings support the utility of shorter combined programs and the potential value of exercise TcPO2 in selecting responsive patients.