Structured exercise therapy for lower extremity peripheral arterial disease: Difference between revisions
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In patients with claudication, a supervised exercise program is recommended to improve functional status and QoL and to reduce leg symptoms''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' In patients with [[claudication]], a supervised exercise program is recommended to improve functional status and QoL and to reduce leg symptoms.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
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| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' A supervised exercise program should be discussed as a treatment option for claudication before possible revascularization.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])''<nowiki>"</nowiki> | ||
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| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | | colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''In patients with PAD, a structured community- or home-based exercise program with behavioral change techniques can be beneficial to improve walking ability | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.'''In patients with PAD, a structured community- or home-based exercise program with behavioral change techniques can be beneficial to improve walking ability and functional status.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
and functional status.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | |||
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| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''In patients with claudication, alternative strategies of exercise therapy, including upper-body ergometry, cycling, and pain-free or low-intensity walking that avoids moderate-to-maximum claudication while walking, can be beneficial to improve walking ability and functional status''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: | | bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.'''In patients with [[claudication]], alternative strategies of exercise therapy, including upper-body ergometry, cycling, and pain-free or low-intensity walking that avoids moderate-to-maximum claudication while walking, can be beneficial to improve walking ability and functional status.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki> | ||
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{| class="wikitable" | {| class="wikitable" | ||
! | !Supervised vs Structured Exercise Programs for PAD* | ||
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====Supervised exercise program==== | |||
* Program takes place in a hospital or outpatient facility. | |||
* | * Program uses intermittent walking exercise as the treatment modality. | ||
* | * Program can be standalone or within a cardiac rehabilitation program. | ||
** | * Program is directly supervised by qualified healthcare provider(s). | ||
* | * Training is performed for a minimum of 30–45 min/session; sessions are performed at least 3 times/wk for a minimum of 12 wk (36-46). | ||
* | * Training involves intermittent bouts of walking to moderate-to-maximum claudication, alternating with periods of rest. | ||
* Warm-up and cool-down periods precede and follow each session of walking. | |||
* | ====Structured community- or home-based exercise program==== | ||
* | * Program takes place in the personal setting of the patient rather than in a clinical setting. | ||
* | * Program is self-directed with guidance of healthcare providers. | ||
* | *Healthcare providers prescribe an exercise regimen similar to that of a supervised program. | ||
* Patient counseling ensures understanding of how to begin and maintain the program and how to progress the difficulty of the walking (by increasing distance or speed). | |||
* | *Program may incorporate behavioral change techniques, such as health coaching or use of activity monitors. | ||
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|<small><small>*Adapted from 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease | |<small><small>*Adapted from 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease |
Latest revision as of 20:46, 22 November 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]
2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease[1]
Recommendations for Structured Exercise Therapy in Patients with PAD
Class I |
"1. In patients with claudication, a supervised exercise program is recommended to improve functional status and QoL and to reduce leg symptoms.(Level of Evidence: A)" |
"2. A supervised exercise program should be discussed as a treatment option for claudication before possible revascularization.(Level of Evidence: B-R)" |
Class IIa |
"1.In patients with PAD, a structured community- or home-based exercise program with behavioral change techniques can be beneficial to improve walking ability and functional status.(Level of Evidence: A)" |
"2.In patients with claudication, alternative strategies of exercise therapy, including upper-body ergometry, cycling, and pain-free or low-intensity walking that avoids moderate-to-maximum claudication while walking, can be beneficial to improve walking ability and functional status.(Level of Evidence: A)" |
Supervised vs Structured Exercise Programs for PAD* |
---|
Supervised exercise program
Structured community- or home-based exercise program
|
*Adapted from 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease |
References
- ↑ Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE; et al. (2016). "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines". Circulation. doi:10.1161/CIR.0000000000000471. PMID 27840333.