Abstract
Intermittent claudication is a symptom of atherosclerosis of the lower limbs (peripheral arterial disease (PAD)) and is characterized by pain and cramps of lower limb muscles during exercise. Claudication leads to a reduction in physical activity of patients. PAD is a systemic disease. Atherosclerotic lesions located in the arteries of the lower limbs not only pose the risk of the ischemic limb loss, but above all, they are an important prognostic factor. Patients with claudication are at significant risk of cardiovascular complications such as infarcts or strokes. Comprehensive rehabilitation of patients with intermittent claudication based on the current TASC II (Inter-Society Consensus for the Management of Peripheral Arterial Disease) guidelines, ESC (European Society of Cardiology) guidelines, and AHA (American Heart Association) guidelines includes supervised treadmill training, training on a bicycle ergometer, Nordic Walking, resistance exercises of lower limb muscles, and exercises of upper limbs. A trained, educated, and motivated patient has a chance to improve life quality as well as life expectancy.
Highlights
One of the most common causes of disease and death in the Western world is atherosclerosis. e process is characterized by the formation of atherosclerotic plaques that narrow the lumen of the arteries, and its clinical symptoms depend on the location of the lesions
It may present as coronary artery disease, cerebrovascular disease, and renal artery stenosis or peripheral arterial disease. e latter disorder (PAD) consists in narrowing and total occlusion of the main vessels supplying the lower limbs [2]. is results in pain and disturbances in the economics of walking, which limits the ability to ambulate and decreases physical activity of the patients. It forms a significant problem for the physiotherapist. e rehabilitation is complex. It must take into account the risk of amputation of ischemic lower limbs and reduced quality of life but above all the fact that limb ischemia is an important prognostic factor of general cardiovascular complications [3]. erefore, kinesitherapy in patients with atherosclerotic lower limb ischemia apart from rehabilitation of locomotive disturbances must take into account the elements of cardiac rehabilitation [4]
I.e., pain-free walking distance (PFWD), is the distance traveled before any pain occurs
Summary
One of the most common causes of disease and death in the Western world is atherosclerosis. e process is characterized by the formation of atherosclerotic plaques that narrow the lumen of the arteries, and its clinical symptoms depend on the location of the lesions. Is results in pain and disturbances in the economics of walking, which limits the ability to ambulate and decreases physical activity of the patients It forms a significant problem for the physiotherapist. It is characterized by cramp and pain of a given muscle group. During exercise, narrowed or occluded arteries supplying the muscles of the lower limbs limit the necessary increase in blood flow, which results in disproportions between metabolic demand and oxygen supply and is associated with the occurrence of claudication [5]. E maximal claudication distance (MCD) is defined as the distance after which the patient is forced to stop because of severe pain and muscle cramps. In patients with PAD, ABI values fall below 0.9, and below 0.4, it correlates with critical limb ischemia [12]. Lesions may occur in multiple sections of the arterial system, and it usually follows more advanced stage of atherosclerosis [18]
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