Walking exercise in patients with intermittent claudication. Experience in routine clinical practice.
BACKGROUND
In patients with intermittent claudication, exercise in the form of walking is effective in reducing pain and maximising achievable walking distance. However, data are lacking on the implementation of walking exercise in these patients.


OBJECTIVE
To explore the current behaviour and views of patients with intermittent claudication towards taking walking exercise.


METHODS
Postal questionnaire and focus group meetings.


METHODS
Two academic general practice networks (Utrecht and Maastricht Universities) in The Netherlands.


METHODS
Three hundred and seventy-five patients with intermittent claudication, selected from the files of general practitioners participating in two academic general practice networks, were sent a postal questionnaire; 216 (58%) were returned. Nine of these responders also attended a focus group meeting.


RESULTS
Seventy per cent (151/216) of the patients reported having received advice about walking exercise. If specified, the advice given most often recommended walking in the local neighbourhood (56%, 84/151). Fifty-two per cent (113/216) of all patients actually performed walking exercise and only 32%of them received any kind of supervision. Among the barriers for taking walking exercise, 'comorbidity', 'lack of (specific) advice' and 'lack of supervision' were often mentioned. Among the stimuli to start and continue walking, 'following the doctor's advice', 'relief of complaints' and 'a better general condition' were often mentioned by patients.


CONCLUSIONS
Walking exercise was not carried out by almost half of patients with intermittent claudication in this study. Lack of specific advice and supervision were found to be important barriers to taking walking exercise.
University Medical Centre Utrecht, Julius Center for Health Sciences and Primary Care Utrecht, The Netherlands. m.e.l.bartelink@med.uu.nl
Marie-Louise
ML
Bartelink
Henri E J H
HE
Stoffers
Cornelis J
CJ
Biesheuvel
Arno W
AW
Hoes
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005081:Exercise Therapy / Q000379:methods*; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010353:Patient Education as Topic / Q000379:methods; D012017:Referral and Consultation; D016138:Walking / Q000523:psychology*