Integration of People With Peripheral Artery Disease Into Cardiac Rehabilitation Exercise Programs: A Scoping Review

Area of Science:

• Cardiovascular Medicine
• Rehabilitation Science
• Clinical Exercise Physiology

Background:

• Supervised exercise therapy is a key recommendation for peripheral artery disease (PAD) management.
• Access to specialized exercise programs for PAD is often limited.
• Cardiac rehabilitation (CR) offers a potential avenue for broader exercise therapy access.

Purpose of the Study:

• To review the characteristics and quality of studies integrating PAD patients into CR programs.
• To assess the evidence supporting CR efficacy in individuals with PAD.

Main Methods:

• A systematic literature search was conducted across major electronic databases.
• Included studies focused on exercise-based CR integrating individuals with PAD.
• 21 studies with 4095 participants were included; only 2 were randomized controlled trials.

Main Results:

• Most participants (68%) had PAD as a comorbidity alongside cardiac disease.
• Only 5 studies fully adhered to PAD exercise recommendations.
• CR showed associations with improved walking capacity, quality of life, and long-term mortality/morbidity, despite limited high-quality data.

Conclusions:

• There is a low number of randomized controlled trials evaluating CR for PAD.
• Further high-quality research is necessary to confirm CR's efficacy in PAD.
• Future trials should incorporate PAD-specific exercise recommendations and outcome measures.