title: Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial.
abstract: BACKGROUND
  Exercise training may have the potential to improve post-thrombotic syndrome, a frequent, chronic complication of deep venous thrombosis. We conducted a randomized controlled two-centre pilot trial to assess the feasibility of a multicentre-based evaluation of a six-month exercise training program to treat post-thrombotic syndrome and to obtain preliminary data on the effectiveness of such a program.
  
  
  METHODS
  Patients were randomized to receive exercise training (a six-month trainer-supervised program) or control treatment (an education session with monthly phone follow-ups). Levels of eligibility, consent, adherence and retention were used as indicators of study feasibility. Primary outcomes were change from baseline to six months in venous disease-specific quality of life (as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life [VEINES-QOL] questionnaire) and severity of post-thrombotic syndrome (as measured by scores on the Villalta scale) in the exercise training group versus the control group, assessed by t tests. Secondary outcomes were change in generic quality of life (as measured using the Short-Form Health Survey-36 [SF-36] questionnaire), category of severity of post-thrombotic syndrome, leg strength, leg flexibility and time on treadmill.
  
  
  RESULTS
  Of 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. Exercise training was associated with improvement in VEINES-QOL scores (exercise training mean change 6.0, standard deviation [SD] 5.1 v. control mean change 1.4, SD 7.2; difference 4.6, 95% CI 0.54 to 8.7; p = 0.027) and improvement in scores on the Villalta scale (exercise training mean change -3.6, SD 3.7 v. control mean change -1.6, SD 4.3; difference -2.0, 95% CI -4.6 to 0.6; p = 0.14). Most secondary outcomes also showed greater improvement in the exercise training group.
  
  
  CONCLUSIONS
  Exercise training may improve post-thrombotic syndrome. It would be feasible to definitively evaluate exercise training as a treatment for post-thrombotic syndrome in a large multicentre trial.
authors.affiliation: Department of Medicine, McGill University, Ottawa, Ont., Canada. susan.kahn@mcgill.ca
authors.forename: Susan R
authors.initials: SR
authors.lastname: Kahn
authors.forename: Ian
authors.initials: I
authors.lastname: Shrier
authors.forename: Stan
authors.initials: S
authors.lastname: Shapiro
authors.forename: Adrielle H
authors.initials: AH
authors.lastname: Houweling
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Hirsch
authors.forename: Robert D
authors.initials: RD
authors.lastname: Reid
authors.forename: Clive
authors.initials: C
authors.lastname: Kearon
authors.forename: Khalil
authors.initials: K
authors.lastname: Rabhi
authors.forename: Marc A
authors.initials: MA
authors.lastname: Rodger
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kovacs
authors.forename: David R
authors.initials: DR
authors.lastname: Anderson
authors.forename: Philip S
authors.initials: PS
authors.lastname: Wells
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015444:Exercise; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D054070:Postthrombotic Syndrome / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult