Exercise rehabilitation programs for the treatment of claudication pain
Deutscher übersetzter Titel: | Rehabilitative Trainingsprogramme zur Behandlung der Claudicatio intermittens |
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Autor: | Gardner, A.W.; Poehlman, E.T. |
Erschienen in: | Journal of the American Medical Association |
Veröffentlicht: | 274 (1995), 12, S. 975-980, Lit. |
Format: | Literatur (SPOLIT) |
Publikationstyp: | Zeitschriftenartikel |
Medienart: | Gedruckte Ressource |
Sprache: | Englisch |
ISSN: | 0254-9077, 1538-3598, 0002-9955, 0098-7484 |
Schlagworte: | |
Online Zugang: | |
Erfassungsnummer: | PU199708206722 |
Quelle: | BISp |
Abstract des Autors
Objective: To identify the components of exercise rehabilitation programs that were most effective in improving claudication pain symptoms in patients with peripheral arterial disease. Data Sources: English-language articles were identified by a computer search using Index Medicus and MEDLINE, followed by an extensive bibliography review. Study Selection: Studies were included if thex provided the mean or individual walking distances or times to the onset of claudication pain and to maximal pain during a treadmill test before and after rehabilitation. Data Extraction: Walking distances and times and characteristics of the exercise programs were independently abstracted by two observers. Data Synthesis: Thirty-three English-language studies were identified, of which 21 met the inclusion criteria. Overall, following a program of exercise rehabilitation, the distance (mean+/-SD) to onset of claudication pain increased 179% from 125.9+/-57.3 m to 351.2+/-188.7 m (P<.001), and the distance to maximal claudication pain increased 122% from 325.8+/-148.1 m to 723.3+/-591.5 m (P<.001). The greatest improvement in pain distances occurred with the following exercise program: duration greater than 30 minutes per session, frequency of at least thee sessions per week, walking used as the mode of exercise, use of near-maximal pain during training as claudication pain end point, and program length of greater than 6 months. However, the claudication pain end point, program length, and mode of exercise were the only independent predictors (P<.001) for improvement in distances. Conclusions: The optimal exercise program for improving claudication pain distances in patients with peripheral arterial disease uses intermittent walking to near-maximal pain during a program of at least 6 months. Such a program should be part of the standard medical care for patients with intermittent claudication. Verf.-Referat