Menard Julie R, Smith Hadley E, Riebe Deborah, Braun Christina M, Blissmer Bryan, Patterson Robert B
Department of Physical Education and Exercise Science, University of Rhode Island, Kingston, RI, USA.
J Vasc Surg. 2004 Jun;39(6):1186-92. doi: 10.1016/j.jvs.2004.01.034.
Although the Peripheral Arterial Disease Rehabilitation Program (PADRx) improves walking ability and quality of life over brief periods of follow-up, the long-term durability of results has not been established. This study examined functional status, walking ability, and quality of life in patients several months after completion of a 12-week PADRx.
Patients who completed a PADRx were eligible for participation. A Medical Outcomes Study 36-Item Short Form (SF-36), Walking Impairment Questionnaire (WIQ), and physical activity questionnaire were administered by telephone. A progressive treadmill test was performed on-site.
Of 63 eligible patients, 14 were lost to follow-up, 11 refused participation, and four died. Thirty-four patients had completed PADRx 20 to 80 months previously (mean, 48.2 +/- 13.7 months), and completed the phone survey. Fifteen patients reported exercising a minimum of 60 min/wk for 3 months (EX group), and 19 had not exercised in the preceding 3 months (SED group). Self-reported SF-36 values were significantly different between the EX and SED groups for Physical Function (43.3 +/- 8.2 vs 34.2 +/- 7.8), Role-Physical Function (41.2 +/- 7.7 vs 32.8 +/- 9.2), and Bodily Pain (46.9 +/- 8.8 vs 38.9 +/- 7.1), as well as the Physical Composite (43.5 +/- 6.5 vs 34.0 vs 5.8) domains of the SF-36. Similarly the WIQ demonstrated significant differences in Walking Distance (46.8 +/- 36.2 vs 7.8 +/- 9.4), Walking Speed (47.5 +/- 32.6 vs 14.5 +/- 13.9), and Stair Climbing (60.6 +/- 36.6 vs 37.1 +/- 27.6), favoring the EX group. Sixteen patients, equally distributed between the EX and SED groups, completed the progressive treadmill test. Both groups had experienced improvement (P <.05) in claudication pain time and maximal walking time after completing the 12-week supervised program. The EX group maintained increased claudication pain time of 121% and maximum walking time of 109% over baseline, whereas the SED group values had returned to baseline (P <.05).
Patients with claudication realize symptomatic and functional improvement with supervised exercise programs. Those who continue to exercise will potentially maintain these benefits and experience improved health-related quality of life.
尽管外周动脉疾病康复计划（PADRx）在短期随访中可改善步行能力和生活质量，但结果的长期持续性尚未得到证实。本研究调查了完成12周PADRx几个月后的患者的功能状态、步行能力和生活质量。
完成PADRx的患者有资格参与。通过电话进行医学结局研究36项简表（SF-36）、步行障碍问卷（WIQ）和体力活动问卷的调查。在现场进行递增式跑步机测试。
63名符合条件的患者中，14名失访，11名拒绝参与，4名死亡。34名患者在20至80个月前（平均48.2±13.7个月）完成了PADRx，并完成了电话调查。15名患者报告每周至少锻炼60分钟，持续3个月（锻炼组），19名患者在之前3个月未锻炼（久坐组）。锻炼组和久坐组在SF-36的身体功能（43.3±8.2对34.2±7.8）、角色-身体功能（41.2±7.7对32.8±9.2）、身体疼痛（46.9±8.8对38.9±7.1）以及SF-36的身体综合评分（43.5±6.5对34.0±5.8）方面自我报告的值有显著差异。同样，WIQ在步行距离（46.8±36.2对7.8±9.4）、步行速度（47.5±32.6对14.5±13.9）和爬楼梯能力（60.6±36.6对37.1±27.6）方面显示出显著差异，锻炼组更具优势。16名患者，锻炼组和久坐组各8名，完成了递增式跑步机测试。两组在完成12周的监督计划后，间歇性跛行疼痛时间和最大步行时间均有改善（P<.05）。锻炼组的间歇性跛行疼痛时间比基线增加了121%，最大步行时间增加了109%，而久坐组的值已恢复到基线水平（P<.05）。
间歇性跛行患者通过监督锻炼计划可实现症状和功能改善。持续锻炼的患者可能会维持这些益处，并体验到与健康相关的生活质量的提高。
