Long-term efficacy of a home-based training program coupled to education for patients with intermittent claudication

Abstract

There are emerging evidences of efficacy of home-based exercise programs for peripheral artery disease (PAD) patients who suffer from intermittent claudication (IC), especially when they are coupled with educational programs (HEP - EPs). We have previously reported the positive one-year results of a specific 3 months home-based exercise program combined with therapeutic education. In this work, we aimed to evaluate the long-term effect of this program (24 months) in walking distance improvement. The secondary objective of the study was to evaluate the long-term results of our program for patients with aorto-iliac lesions. Patients with an ankle-brachial index (ABI) below 0.9 in at least one limb, and an absolute claudication distance (ACD) ≤ 500 meters, were included in the study. During the first three months, patient participated to an educational program with educational workshop, and a weekly telephone coaching. In educational session patients were assisted in delimiting walking objectives. Functional parameters were evaluated at 0, 12, and 24 months. Between Feb 2014 and Jan 2019, 112 and 39 PAD patients with IC completed the 12- and 24-month follow-up, respectively. More than a third of the population (42 patients) had significant aorto-iliac artery lesions. In both the overall population and the group of patients with aorto-iliac lesions, the mean initial claudication distance (ICD) increased by 3 times and the mean absolute claudication distance (ACD) by 2, compared to baseline values at 24-month follow-up ( Fig. 1 ). The results of our study indicate that home-based training combined with therapeutic educational programs for patients with PAD who suffer from IC, have a clear long-term beneficial effect in walking performance at 24 months. Patients with aorto-iliac disease can benefit equally from this program than patients with femoral lesions.