Supervised vs home exercise to treat intermittent claudication
Intermittent claudication is a diagnosis for muscle pain (ache, cramp, numbness, or sense of fatigue) typically in the calf muscle, which occurs during exercise and is relieved by a short period of rest.
Researchers at Oklahoma University Health Sciences Center, in Oklahoma City, compared home-based exercise to a supervised exercise program.
First, the details.
- 119 patients were randomly assigned to a treatment group.
- Home-based exercise: intermittent walking to nearly maximal claudication pain for 12 weeks
- Supervised exercise: as above but supervised
- Usual-care
- Patients wore a step activity monitor during each exercise session.
- Claudication onset time and peak walking time obtained from a treadmill exercise test were recorded as the primary outcomes.
- Daily ambulatory cadences (measure or beat of movement) measured during a 7-day period were also recorded.
And, the results.
- Adherence to home-based and supervised exercise was similar and exceeded 80%.
- Both exercise programs significantly delayed claudication onset time and increased peak walking time.
- Only home-based exercise increased daily average cadence significantly.
- There were no changes in the usual care group.
The bottom line?
The authors concluded, “A home-based exercise program… has high adherence and is efficacious in improving claudication measures similar to a standard supervised exercise program. Furthermore, home-based exercise appears more efficacious in increasing daily ambulatory activity in the community setting than supervised exercise.”
The authors tell us this is the first well-designed study to compare supervised vs home exercise for intermittent claudication. The findings suggest reconsidering the role of supervised exercise in these patients.
4/21/11 22:04 JR