Evidence-based Therapy in Vascular Surgery by E. Sebastian Debus & Reinhart T. Grundmann

Author:E. Sebastian Debus & Reinhart T. Grundmann
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Specific problems

In most studies, SET consists of treadmill or track walking. However, alternative modes of exercise therapy have been described. Lauret et al. (2014) assessed the effects of different modes of SET on the maximum walking distance of patients with IC in a Cochrane review. Five studies comparing supervised walking exercise and alternative modes of exercise were found. The alternative modes of exercise therapy included cycling, strength training, and upper-arm ergometry. The studies represented a sample size of 135 participants with a low risk of bias. Overall, there was no clear evidence of a difference between supervised walking exercise and alternative modes of exercise in maximum walking distance on a treadmill or in pain-free walking distance. The results indicate that alternative exercise modes may be useful when supervised walking exercise is not an option for the patient.

Occasionally, there is concern regarding the safety of performing SET because IC patients are at risk for untoward cardiovascular events. Gommans, Fokkenrood et al. (2015a) found 74 studies representing 82,725 h of training in 2876 IC patients. Eight adverse events were reported, six of cardiac and two of noncardiac origin, resulting in an all-cause complication rate of one event per 10,340 patient-hours. Thus, supervised exercise therapy can safely be prescribed in patients with IC because an exceedingly low all-cause complication rate was found. Routine cardiac screening before commencing SET is not required.

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