title: Long-term effects of structured home-based exercise program on functional capacity and quality of life in patients with intermittent claudication.
abstract: OBJECTIVE
  To evaluate effects of a structured home-based exercise program on functional capacity and quality of life (QoL) in patients with intermittent claudication (IC) after 1-year follow-up, and to compare these results with those from a concurrent control group who received supervised exercise training (SET).
  
  
  METHODS
  Comparative longitudinal cohort study.
  
  
  METHODS
  Referral center.
  
  
  METHODS
  Patients (N=142) with IC.
  
  
  METHODS
  Structured home-based exercise training or SET.
  
  
  METHODS
  The maximum (pain-free) walking distance and the ankle-brachial index (ABI) (at rest and postexercise) were measured at baseline and after 6 and 12 months' follow-up. Additionally, QoL was evaluated using a self-administered questionnaire consisting of the Euroqol-5D (scale 0-1), rating scale (scale 0-100), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36; scale 0-100), and the Vascular Quality of Life Questionnaire (VascuQol; scale 1-7). Comparison of the groups was performed with adjustment for the nonrandomized setting using propensity scoring.
  
  
  RESULTS
  One hundred forty-two patients with IC started the structured home-based exercise program, of whom 95 (67%) completed 12 months' follow-up. The mean relative improvement compared with baseline was statistically significant after 12 months' follow-up for the maximum and pain-free walking distance (342%, 95% confidence interval [CI], 169-516; P<.01 and 338%, 95% CI, 42-635; P=.03, respectively) and for the ABI postexercise (mean change, .06; 95% CI, .01-.10; P=.02). For the QoL outcomes, the improvement compared with baseline was statistically significant after 12 months for the VascuQol (mean change, .42; 95% CI, .20-.65; P<.01) and for the SF-36 physical functioning (mean change, 5.17; 95% CI, .77-9.56; P=.02). Compared with the structured home-based exercise program, patients in the control group showed significantly better results in the mean relative improvement of maximum and pain-free walking distance and change in the ABI at rest after 12 months' follow-up.
  
  
  CONCLUSIONS
  Structured home-based exercise training is effective in improving both functional capacity and QoL in patients with IC and may be considered as a feasible and valuable alternative toSET, since supervised exercise programs are not often available.
authors.affiliation: Department of Epidemiology, Erasmus MC- University Medical Center Rotterdam, The Netherlands.
authors.forename: Farzin
authors.initials: F
authors.lastname: Fakhry
authors.forename: Sandra
authors.initials: S
authors.lastname: Spronk
authors.forename: Maria
authors.initials: M
authors.lastname: de Ridder
authors.forename: Pieter T
authors.initials: PT
authors.lastname: den Hoed
authors.forename: M G Myriam
authors.initials: MG
authors.lastname: Hunink
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010146:Pain / Q000503:physiopathology; D058729:Peripheral Arterial Disease / Q000150:complications; D010807:Physical Endurance; D011788:Quality of Life; D016138:Walking / Q000502:physiology