Multidisciplinary Formulation of a Walking Rehabilitation Nursing Protocol for Patients with Lower Extremity...

To develop a contextually tailored walking rehabilitation protocol for Chinese patients with lower extremity arteriosclerosis obliterans (ASO), providing evidence-based theoretical and practical guidance for clinical nursing.

Lower extremity ASO is a prevalent chronic vascular disease with rising incidence, high morbidity, and mortality. Exercise interventions effectively improve patients' walking ability, and supervised walking programs are promising, yet standardized clinical guidelines remain lacking.

An evidence-based protocol was developed via systematic review of domestic and international literature. A preliminary draft was refined through two rounds of Delphi consultations with 20 multidisciplinary experts (vascular surgery, nursing, rehabilitation). Statistical analysis of expert agreement finalized the standardized protocol.

Both rounds achieved a 100% response rate. Expert authority coefficients were 0.918 (Round 1) and 0.945 (Round 2). Coefficients of variation ranged 0.00-0.21 (Round 1) and 0.00-0.10 (Round 2). Kendall's concordance coefficients were 0.131 and 0.339 (p<0.05), indicating significant consensus. The final protocol includes 5 primary, 13 secondary, and 40 tertiary indicators.

This Delphi-derived standardized walking rehabilitation protocol addresses gaps in current guidelines and provides an evidence-based foundation for standardized Lower extremity ASO interventions.