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Outcomes of 475 Patients referred to Supervised Exercise Therapy for Treatment of Claudication
Allie K Olmstead, Samuel Steerman
Eastern Virginia Medical School, Norfolk, VA
INTRODUCTION:Peripheral artery disease (PAD) affects around 20 million people in the United States. Vascular rehabilitation or, supervised exercise therapy (SET), programs that combine monitored exercise with counseling on lifestyle changes (diet, smoking cessation) have been shown to be effective in PAD treatment. SET is typically twelve weeks long, with sessions occurring three times a week, and is mostly treadmill-based therapy. This study aims to examine the improvement in patient's quality of life and walking tolerance in those that attended and completed SET
METHODS:A retrospective analysis was performed of a prospectively collected database for all patients referred for SET within a single Healthcare System from 2016-2023.Outcomes examined were: improvement in quality of life (utilizing VascuQoL questionnaire, a 25 question questionnaire that examines QOL within the domains of: pain, symptoms, activities, social and emotional , maximum score of 175), and improvement in the patient's six-minute walk test (6MWT) (distance a patient was able to walk within 6 minutes without stopping due to pain, measured in feet). This study also examined reasons why people were referred to SET but did not complete or start the program.
RESULTS:A total of 475 patients were referred to SET within the study period. Of the 475 referred, 235 patients (49%) started the program, with 126 patients (55%) completing the program. Of those that completed the program,71% had an improvement in their 6 MWT (average improvement of 271.6ft, P<.0001) and 82% had an improvement in their VascuQoL score (Pre-SET average 84, post- SET average of 129) (p< .0001). Overall, 94% noted improvement in at least one category. 46% of patients did not start SET, with the most common reasons being: declining to start (17%), other medical issues (15%), insurance issues (5%), Patient did not call back (21.3%), and failure to be contacted for referral (20%). The most common reasons for not completing SET were other medical issues (25%), non-compliance (10.6%). Only 1.3% did not complete due to financial issues
CONCLUSIONS:This real-world analysis of SET showed that 94% of patients experienced an improvement in either ambulation distance or QOL if they were able to complete 12 weeks of therapy. Despite these dramatic results of success, 51% of patients were unable to initiate SET and 45% were unable to complete it. Given these improvements in ambulation and quality of life, the programs could benefit more people if it were more widely available.
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