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Effects of a 12-week Supervised Rehabilitation Exercise Program on Patients With Peripheral Artery Disease With or At
Jérôme Patry1, Emma Fontaine, Andrée-Anne Hébert
1Jérôme Patry, DPM, MD, is Family Physician and Wound Care Physician, Clinique des plaies complexes de l'Hôtel-Dieu de Lévis Hospital Center, Lévis, Canada; Clinical Professor, Laval University Faculty of Medicine, Québec City; Faculty Lecturer, Podiatric Medicine program, Université du Québec à Trois-Rivières; and Researcher, Centre de recherche du CISSS de Chaudière-Appalaches and at VITAM - Sustainable Health Research Center, Québec City. Emma Fontaine, MD(c), is Medical Student, Laval University Faculty of Medicine. Andrée-Anne Hébert, BSc, is Certified Exercise Physiologist, PREV Cardiovascular Rehabilitation Program, CISSS de Chaudière-Appalaches - Hôtel-Dieu de Lévis Hospital Center. Marie-Kristelle Ross, MD, is Cardiologist at Hôtel-Dieu de Lévis Hospital Center, Head of Medical Service, PREV Cardiovascular Rehabilitation Program, CISSS de Chaudière-Appalaches, and Researcher, Centre de recherche du CISSS de Chaudière-Appalaches, Sainte-marie. Magali Brousseau-Foley DPM, MD, PhD(c), is Professor, Department of Human Kinetics and Podiatric Medicine at Université du Québec à Trois-Rivières and Clinical Professor, Université de Montréal Medicine Faculty.
Objective:
The aim of this study was to describe a cohort of patients participating in a 12-week supervised exercise program as part of a comprehensive cardiovascular rehabilitation program for patients with peripheral artery disease (PAD) with or at risk of wound on maximal walking distance, wound healing, and cardiovascular outcomes in the year following participation.
Methods:
A retrospective cohort study was conducted, and all adult patients with PAD admitted to the rehabilitation program between January 1, 2021, and January 1, 2023 were included.
Results:
Forty-two patients with PAD were enrolled, of whom 85.7% had intermittent claudication and 38.1% had severe PAD (toe pressure measurement <30 mm Hg). Mean maximal walking distance at the 6-minute walking test was 301.8 m (median: 300.0, SD: 106.3) at baseline and increased to 408.3 m (median: 440, SD: 123.8) at the end of the program. All patients with a wound at baseline (n = 8) were healed, except for 1 patient who died before healing. One year following the program, only 1 patient developed a new wound, 4 benefited from a percutaneous angioplasty, none required a surgical revascularization, and 1 had a major lower limb amputation.
Conclusions:
A 12-week supervised exercise program appears beneficial to improve walking distance for patients with moderate to severe PAD. It also appears safe for patients with or at risk of a lower limb wound, providing tailored exercises prespecified for each patient and adequate supervision. However, prospective studies are required before making clinical recommendations of such a program for the at-risk foot with PAD.
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