Long-Term Effects of Structured Home-Based Exercise Program on Functional Capacity and Quality of Life in Patients With Intermittent Claudication

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• 作者：Farzin Fakhry ; MSc^a ; Sandra Spronk ; PhD^a ; ^c ; ^{s.spronk@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author} ; Maria de Ridder ; PhD^b ; Pieter T. den Hoed ; MD ; PhD^d ; M.G. Myriam Hunink ; MD ; PhD^a ; ^c ; ^e
• 关键词：Exercise ; Intermittent claudication ; Outcome assessment (health care) ; Peripheral arterial disease ; Quality of life ; Rehabilitation
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：92
• 期：7
• 页码：1066-1073
• 全文大小：497 K

文摘

Fakhry F, Spronk S, de Ridder M, den Hoed PT, Hunink MGM. Long-term effects of structured home-based exercise program on functional capacity and quality of life in patients with intermittent claudication.

Objectives

To evaluate effects of a structured home-based exercise program on functional capacity and quality of life (QoL) in patients with intermittent claudication (IC) after 1-year follow-up, and to compare these results with those from a concurrent control group who received supervised exercise training (SET).

Design

Comparative longitudinal cohort study.

Setting

Referral center.

Participants

Patients (N=142) with IC.

Interventions

Structured home-based exercise training or SET.

Main Outcome Measures

The maximum (pain-free) walking distance and the ankle-brachial index (ABI) (at rest and postexercise) were measured at baseline and after 6 and 12 months' follow-up. Additionally, QoL was evaluated using a self-administered questionnaire consisting of the Euroqol-5D (scale 0–1), rating scale (scale 0–100), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36; scale 0–100), and the Vascular Quality of Life Questionnaire (VascuQol; scale 1–7). Comparison of the groups was performed with adjustment for the nonrandomized setting using propensity scoring.

Results

One hundred forty-two patients with IC started the structured home-based exercise program, of whom 95 (67%) completed 12 months' follow-up. The mean relative improvement compared with baseline was statistically significant after 12 months' follow-up for the maximum and pain-free walking distance (342%, 95% confidence interval [CI], 169–516; P<.01 and 338%, 95% CI, 42–635; P=.03, respectively) and for the ABI postexercise (mean change, .06; 95% CI, .01–.10; P=.02). For the QoL outcomes, the improvement compared with baseline was statistically significant after 12 months for the VascuQol (mean change, .42; 95% CI, .20–.65; P<.01) and for the SF-36 physical functioning (mean change, 5.17; 95% CI, .77–9.56; P=.02). Compared with the structured home-based exercise program, patients in the control group showed significantly better results in the mean relative improvement of maximum and pain-free walking distance and change in the ABI at rest after 12 months' follow-up.

Conclusions

Structured home-based exercise training is effective in improving both functional capacity and QoL in patients with IC and may be considered as a feasible and valuable alternative toSET, since supervised exercise programs are not often available.