Implementation and evaluation of a supervised exercise programme for people with claudication in York, England.

Area of Science:

• Vascular Medicine
• Rehabilitation Science
• Health Services Research

Background:

• Supervised exercise therapy (SET) is a guideline-recommended first-line treatment for peripheral artery disease (PAD) claudication.
• Despite recommendations, SET program implementation remains limited globally.
• This project focused on implementing and evaluating a SET service for claudication in York, England.

Purpose of the Study:

• To implement a supervised exercise program for patients experiencing claudication due to PAD.
• To evaluate the feasibility, acceptability, fidelity, and preliminary effects of the new service.
• To assess the cost-effectiveness of the implemented exercise service.

Main Methods:

• The York Claudication Exercise Service offered two 1-hour sessions weekly for 12 weeks.
• Standardized pre- and post-programme assessments measured outcomes including walking distances.
• Descriptive statistics and cost-comparison analysis were used to evaluate the service's first 12 months.

Main Results:

• 29 patients (44.6%) commenced the program, attending a median of 19 sessions.
• 59.1% of participants reported improved claudication symptoms, with a mean pain-free walking distance increase of 110m.
• The service achieved high patient satisfaction and estimated annual cost savings of £223-£366 per person.

Conclusions:

• The supervised exercise service was successfully integrated into the existing care pathway.
• The service demonstrated high patient satisfaction, symptom improvement, and reduced unnecessary vascular referrals.
• The program will continue for at least two more years, with efforts to improve access and uptake.