Vascular rehabilitation: benefits of a structured exercise/risk modification program.
A vascular rehabilitation program was designed to increase exercise tolerance and reduce the risk of cardiovascular disease in patients with lower extremity arterial occlusive disease. Sixty-eight patients (32 men, 36 women); ages 55 to 85 years (mean, 68 years) with claudication 30 (44%), or recovering from lower extremity revascularization 36 (53%), or endovascular procedures 2 (3%) entered the vascular rehabilitation program. Each underwent a physical examination, risk factor assessment, noninvasive arterial studies, and cardiac evaluation. A history was taken from each patient also. Six patients (9%) were excluded on recognition of silent myocardial ischemia. Sixty-two patients (91%) were accepted for exercise training in a program designed to offer 24 (1-hour) monitored exercise sessions, 12 (1-hour) personalized education lectures, and development of a home maintenance exercise program. No deaths or major morbidity occurred. Seventeen patients (27%) did not finish the program, eight (13%) because of development of significant cardiac, extremity, or cerebrovascular disease and nine for nonmedical reasons. Of the 45 patients (73%) who completed the program, 38 (88%) had documented increases in walking distances of greater than 100% (122% to 450%). All 45 patients designed home exercise programs, and 88% of the smokers quit. Long-term follow-up was available on 100% of the patients. Thirty-eight patients (84%) have been followed for 2 years or more. Thirty-eight (84%) maintained or improved walking distances recorded on exit from the program. Thirty of the 36 patients (83%) who stopped smoking remained nonsmokers. Significant reductions in cholesterol were seen at 1 year, and significant reductions in triglycerides were seen at 12 weeks and 1 year.(ABSTRACT TRUNCATED AT 250 WORDS)
Williams
L R
LR
Saint Anthony's Hospital, St. Petersburg, FL.
Ekers
M A
MA
Collins
P S
PS
Lee
J F
JF
D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000098:blood supply; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000517:prevention & control; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000517:prevention & control / Q000534:rehabilitation* / Q000601:surgery; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D010806:Physical Education and Training; D012307:Risk Factors; D000074606:Smoking Prevention; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D016138:Walking
D014280:Triglycerides