Predictors of walking distance after supervised exercise therapy in patients with intermittent claudication.
OBJECTIVE
To identify predictor variables for results after supervised exercise therapy (SET), and to develop a clinical prediction model that aims to predict a target walking distance for individual patients.


METHODS
Retrospective analyses on prospectively collected data.


METHODS
Patients with intermittent claudication who participated in a SET programme.


METHODS
SET was conducted according to the guidelines of the Royal Dutch Society for Physiotherapy. The main outcome measurement was the absolute claudication distance (ACD) after 6 months of SET. Linear regression analyses were conducted to identify independent predictor variables for ACD.


RESULTS
In this cohort, 437 patients were analysed. Independent predictor variables for post-treatment ACD were baseline ACD (P<0.001), smoking behaviour (P=0.012) and body-mass index (P=0.041). A better baseline ACD was associated with a longer post-treatment ACD whereas current smoking and a higher body-mass index were associated with a shorter post-treatment ACD. The final regression equation included baseline ACD, age, body-mass index, smoking and pulmonary disease, and was translated into several clinical prediction models. However, only 24.8-33.6% of the patients had an ACD within the calculated target range.


CONCLUSIONS
Predictive variables for post-treatment ACD after SET are baseline ACD, age, body-mass index, pulmonary disease and smoking behaviour. However, translating the regression equation into a clinical prediction model did not lead to a valid model for use in clinical practice.
Kruidenier
L M
LM
Department of Surgery, Atrium Medical Centre Parkstad, Heerlen, The Netherlands.
Nicolaï
S P A
SP
Ten Bosch
J A
JA
de Bie
R A
RA
Prins
M H
MH
Teijink
J A W
JA
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008171:Lung Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome; D016138:Walking