Preferred exercise modalities in patients with intermittent claudication

Amy Elizabeth Harwood, Louise Helen Hitchman, Lee Ingle, Patrick Joseph Doherty, Ian Clifford Chetter

Research output: Contribution to journalArticlepeer-review


Conventional supervised exercise programs (SEPs) for claudicants are traditionally based on time-constrained, groupbased
structured programs usually at a hospital site. Uptake of an SEP is poor, despite the high-level evidence demonstrating
its clinical effectiveness; therefore, alternative forms of exercise programs are needed which are more acceptable
to patients. This study aimed to explore a range of exercise modalities to determine patient preferences for exercise delivery
on a national level. This was a questionnaire survey to identify and incorporate patient preferences when designing
a multicenter nationwide health-service evaluation of patient preference to exercise in the United Kingdom’s National
Health Service (the PREFER study). Patients with documented stable intermittent claudication who were suitable for
an SEP were given a questionnaire to fill out at their clinic visit. Data were recorded using the Bristol Online Survey
tool ( and analyzed descriptively. Thirty complete questionnaires were analyzed. Participants
were generally unilateral claudicants (80%) with symptoms for over 1 year (64%). Only 6 of the 30 patients had
engaged in a lifelong routine of exercise. Eighty-seven percent of patients indicated that they had not taken part in an exercise
program, but 73% of those indicated that they would be willing to participate to improve their walking. Most patients
expressed a preference for a home exercise program (50%) followed by a hospital SEP. The majority of patients
(43%) were happy to exercise 3 days per week using a walking-based program (53%). There was however no consensus
on the duration or intensity of the exercise program. The SEP is the recommended first-line treatment for intermittent claudication
patients; however, the vast majority of patients fail to engage with or complete an exercise program. This study
demonstrates that exercise therapy should be individualized and take a patient-centered approach. Commissioning groups
should incentivize hospitals and clinicians to engage with their patient populations to understand their needs and deliver
an appropriate service
Original languageEnglish
JournalJournal of vascular nursing
Early online date2 Feb 2018
Publication statusE-pub ahead of print - 2 Feb 2018

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© 2018 by the Society for Vascular Nursing, Inc. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

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