title: When is supervised exercise therapy considered useful in peripheral arterial occlusive disease? A nationwide survey among vascular surgeons.
abstract: OBJECTIVE
  Although international guidelines state that supervised exercise therapy (SET) should be offered to all patients with intermittent claudication (IC), SET appears to be underutilised in clinical practice. The aim of this study was to document current opinions of Dutch vascular surgeons on SET as treatment option for peripheral arterial occlusive disease (PAOD).
  
  
  METHODS
  Vascular surgeons and fellows in vascular surgery were asked to complete a 24-question survey either at the 2011 Annual Meeting of the Dutch Society for Vascular Surgery or online.
  
  
  RESULTS
  Ninety-one participants, including 83 vascular surgeons (51% of all Dutch vascular surgeons), completed the survey. The respondents would refer 75.4% of newly diagnosed patients with IC for SET. SET was considered less useful in patients with IC and major (cardiopulmonary) co-morbidity or a significant iliac artery stenosis. In critical limb ischaemia, the combination of SET and angioplasty was considered useful in 71.9%. Respondents regarded patient satisfaction (63.3%) and improvement in pain-free or maximal walking ability (26.6%) as clinically most relevant goals of SET. Most (84.4%) agreed that SET should also include lifestyle management.
  
  
  CONCLUSIONS
  Although the vast majority of Dutch vascular surgeons consider SET as an important treatment option for PAOD, SET should receive more emphasis in clinical practice since arguments not to refer for SET are outdated. Furthermore, vascular surgeons agree that lifestyle management should be integrated in SET.
authors.affiliation: Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lauret
authors.forename: H C
authors.initials: HC
authors.lastname: van Dalen
authors.forename: H J
authors.initials: HJ
authors.lastname: Hendriks
authors.forename: S M
authors.initials: SM
authors.lastname: van Sterkenburg
authors.forename: M J
authors.initials: MJ
authors.lastname: Koelemay
authors.forename: C J
authors.initials: CJ
authors.lastname: Zeebregts
authors.forename: R J
authors.initials: RJ
authors.lastname: Peters
authors.forename: J A
authors.initials: JA
authors.lastname: Teijink
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D017130:Angioplasty / Q000706:statistics & numerical data; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000534:rehabilitation* / Q000628:therapy; D001291:Attitude of Health Personnel; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D040242:Risk Reduction Behavior; D013043:Specialties, Surgical / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires