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Physical training for intermittent claudication: a comparison of structured rehabilitation versus home-based training

Department of Angiology, University of Basel Medical School, Basel, Switzerland

Karl-Heinz Labs

Department of Angiology, University of Basel Medical School, Basel, Switzerland

Jacques Hochstrasser

Institute for Medical Physiotherapy, University of Basel Medical School, Basel, Switzerland

Markus Aschwanden

Department of Angiology, University of Basel Medical School, Basel, Switzerland

Martin Tschoepl

Department of Angiology, University of Basel Medical School, Basel, Switzerland

Kurt A Jaeger

Department of Angiology, University of Basel Medical School, Basel, Switzerland

In a non-randomized, open-label study results after a structured institution-based peripheral arterial occlusive disease (PAD) rehabilitation program were compared with the results of training at home. Three groups were compared: group 1 (n = 19) PAD rehabilitation; group 2 (n = 19) PAD rehabilitation + clopidogrel 75 mg once daily; group 3 (n = 21) home-based training. The training period was 3 months for all groups, which was followed by a 3-month observation phase (without prescribed training). The rehabilitation program consisted of 3 training hours per week. Background variables, demographics, and baseline claudication distances were comparable between groups. After 3 months of training the absolute claudication distances (ACD) improved by 82.7%, 131.4%, and 5.4% for groups 1, 2 and 3. The initial claudication distances (ICD) changed by 163.8%, 200.6%, and 44.4%, respectively. All changes, except the ACD result for group 3, were statistically significant (p 0.05).

Structured training groups (1 and 2) performed significantly better than group 3 (p 0.05). When results from groups 1 and 2 were pooled, ACDs changed from 493.3 218.1 to 1026.0 468.9 m, 546.0 378.8 m [95% CI 417.8 - 674.2 m]; p 0.05. ICDs improved from 175.3 110.8 m to 493.1 326.7 m, 320.8 315.9 m [95% CI 213.9 - 427.7 m]; p 0.05. The difference between the pooled mean results of the structured training groups and the results of group 3 amounted to 474.3 m [95% CI 270.2 - 678.4 m] and 242.4 m [95% CI 99.0 - 385.7 m], for ACD and ICD, respectively.

Structured, supervised PAD rehabilitation is a highly efficacious treatment for intermittent claudication and may be regarded as the present gold standard among conservative treatment options.

Key Words: claudication • exercise • home-based training • peripheral arterial disease • structured training

Vascular Medicine, Vol. 7, No. 2, 109-115 (2002)
DOI: 10.1191/1358863x02vm432oa


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