[Early results of an ambulatory rehabilitation program for medically treated Leriche grade II arterial disease of the lower limb].
OBJECTIVE
We assess the impact of an ambulatory rehabilitation program in patients with Leriche grade II arterial disease.


METHODS
One hundred nineteen patients with Leriche grade II arterial disease of the lower limbs treated medically were included in a totally ambulatory specifically designed vascular rehabilitation program. There were 91 men and 28 women, mean age 64 years. All the patients participated in a two-phase rehabilitation program with clinical and hemodynamic surveillance for 20 weeks. The first phase involved progressive rehabilitation for 8 weeks followed by a maintenance program for 12 weeks. Performance was assessed with the maximum analytic test (MAT) that reproduced the indicated rehabilitation movement to onset of cramps and with walking distance on flat ground under standard conditions using a treadmill.


RESULTS
All patients completed the entire program and non required surgical revascularization. Systolic pressure index at the ankle remained stable at 0.62 for the 20 weeks. At 8 weeks, the patients had improved their baseline MAT 2.22-fold and their walking distance by 1.87-fold. At 20 weeks, these factors were 2.74 for MAT and 2.49 for walking distance. Ninety-one percent of the patients evaluated their baseline walking distance at less than 500 m (mean 210.3 m). At the end of the rehabilitation program, 44% considered their walking distance was between 500 and 1 000 meters. The presence of associated diseases did not hinder implementation of the program.


CONCLUSIONS
Studies evaluating the effect of 6-month regimens of vasoactive agents have generally reported a 1.50-fold improvement. Our outpatient rehabilitation program using treadmill exercises appeared to be more effective, less costly, less demanding for the patients and applicable to a larger number of patients.
Aligne
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Service d'Angiologie, Centre médical de Chavanne, 42400 Saint Chamond.
Zalazar
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D001157:Arterial Occlusive Diseases / Q000145:classification / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors