By the same authors

From the same journal

Systematic review of home-based exercise programmes for individuals with intermittent claudication

Research output: Contribution to journalArticlepeer-review

Published copy (DOI)

Author(s)

  • W Al-Jundi
  • K Madbak
  • J D Beard
  • S Nawaz
  • G A Tew

Department/unit(s)

Publication details

JournalEuropean Journal of Vascular and Endovascular Surgery
DateE-pub ahead of print - 11 Sep 2013
DatePublished (current) - Dec 2013
Issue number6
Volume46
Number of pages17
Pages (from-to)690-706
Early online date11/09/13
Original languageEnglish

Abstract

We aimed to conduct a systematic review of the evidence for structured, home-based exercise programmes (HEPs) in patients with intermittent claudication. The Medline, PsycINFO, EMBASE, and Cochrane databases were searched up to April 2013 for terms related to walking, self-management, and intermittent claudication. Descriptive, methodological and outcome data were extracted from eligible articles. Trial quality was assessed using the GRADE system. Seventeen studies were included with 1,457 participants. Six studies compared HEPs with supervised exercise training, five compared HEPs with usual care/observation control, and seven evaluated HEPs in a single-group design. Trial heterogeneity prevented meta-analysis. Nevertheless, there was "low-level" evidence that HEPs can improve walking capacity and quality of life in patients with intermittent claudication when compared with baseline or in comparison to usual care/observation control. In addition, improvements with HEPs may be inferior to those evoked by supervised exercise training. Considerable uncertainty exists regarding the long-term clinical and cost effectiveness of HEPs in patients with intermittent claudication. Thus, more robust trials are needed to build evidence about these interventions. Nevertheless, clinicians should consider using structured interventions to promote self-managed walking in patients with intermittent claudication, as opposed to simple "go home and walk" advice, when supervised exercise training is unavailable or impractical.

Bibliographical note

© 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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