Graded Exercise Therapy and Six Minute Walk Test: The Modern Care of Peripheral Vascular Disease

Abstract

Peripheral vascular disease (PVD) is a serious condition characterized by obstruction of large arteries in the lower extremity. PVD is one of the leading causes of morbidity in the elderly population; affects their lifestyle and daily practice. Claudication is the primary symptom, defined as cramping in the calf, thigh and hips while doing leg exercises like walking, and climbing stairs. Risk factors are very similar to ischemic heart disease (IHD) including smoking, diabetes mellitus, dyslipidemia, and hypertension. Symptoms and history assessment are significant as are duration of discomfort, pain score and family history. Arteriography, ankle/brachial index (ABI), Doppler ultrasound and CT angiography are the procedures to confirm the PVD. Treadmill stress test (TMT), resting ankle index (RAI) and post-occlusive reactive hyperemia (PORH) are used to determine the diagnostic accuracy. Diet control is an essential step to managing hypertension, high cholesterol, and high sugar. Six-minute walk test is done for functional assessment of PVD. Six-minute walk test is a well-validated measure of walking endurance which doesn’t need any specific training or sophisticated equipment or laboratory. A baseline six-minute walk test has been found to predict rates of mobility loss, all-cause mortality and cardiovascular disease mortality among the patients with PVD. Graded exercise therapy (GET) is a physical activity that starts very slowly and gradually an increase over time. All kind of steps and stretches directly or indirectly improve the lifestyle and morbidity of patients after interventions. Exercise adherence shows long-term success in its kind of patients.