Bø Elisabeth, Bergland Astrid, Stranden Einar, Jørgensen Jørgen J, Sandbaek Gunnar, Grøtta Ole Jørgen, Hisdal Jonny
Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Faculty of Medicine, University of Oslo, Oslo, Norway.
Physiother Res Int. 2015 Sep;20(3):147-57. doi: 10.1002/pri.1608. Epub 2014 Dec 2.
This study aimed to assess the effects of supervised exercise training (SET) after percutaneous transluminal angioplasty (PTA) compared with PTA alone on physical function, limb hemodynamics and health-related quality of life in patients with intermittent claudication.
Fifty patients who all underwent PTA for intermittent claudication were included in the study. Both groups received usual post-operative care. In addition, the intervention group performed two sessions of hospital-based SET and one home-based exercise session per week for 12 weeks after PTA. The control group did not receive any additional follow-up regarding exercise. The primary outcome was the result of a standardized 6-minute walk test. Secondary outcomes were the treadmill maximum walking distance, treadmill pain-free walking distance, ankle-brachial index, pulse volume recording on the leg and ultrasound scanning. Health-related quality of life was measured using the Short Form 36 and the Claudication Scale.
All measures, except for the Short Form 36 domain of mental health, showed statistically significant positive changes from baseline to 3 months for both groups (p < 0.05). At 3 months, there was a trend towards better results for the intervention group compared with the control group. The median improvement from baseline to 3 months for the 6-minute walk test was 66 m for the intervention group and 45 m for the control group. For maximum walking distance, the median improvement was 251 m for the intervention group and 93 m for the control group.
Supervised exercise training after endovascular treatment for patients with intermittent claudication led to greater positive changes after 3 months in the intervention group compared with the control group. The present study's trends of better results with SET after PTA add to the emerging existing evidence, which should encourage physiotherapy practice to offer SET for this patient group.
本研究旨在评估经皮腔内血管成形术（PTA）后，监督性运动训练（SET）相较于单纯PTA对间歇性跛行患者身体功能、肢体血流动力学及健康相关生活质量的影响。
本研究纳入了50例均接受PTA治疗间歇性跛行的患者。两组均接受常规术后护理。此外，干预组在PTA后每周进行两次基于医院的SET训练和一次家庭运动训练，共持续12周。对照组未接受任何额外的运动随访。主要结局为标准化6分钟步行试验的结果。次要结局包括跑步机最大步行距离、跑步机无痛步行距离、踝臂指数、腿部脉搏容积记录及超声扫描。使用简短健康调查问卷36项版本（Short Form 36）和跛行量表测量健康相关生活质量。
除简短健康调查问卷36项版本中的心理健康领域外，两组从基线到3个月的所有测量指标均显示出具有统计学意义的显著正向变化（p < 0.05）。在3个月时，干预组的结果有优于对照组的趋势。从基线到3个月，干预组6分钟步行试验的中位数改善为66米，对照组为45米。对于最大步行距离，干预组的中位数改善为251米，对照组为93米。
与对照组相比，间歇性跛行患者接受血管内治疗后进行监督性运动训练，干预组在3个月后出现了更大的正向变化。本研究中PTA后SET取得更好结果的趋势补充了新出现的现有证据，这应鼓励物理治疗实践为该患者群体提供SET。
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