title: Education and home based training for intermittent claudication: functional effects and quality of life.
abstract: BACKGROUND
  Supervised exercise programs increase physical performance in patients with peripheral artery disease (PAD). However, there are a limited number of programs, and to date they have failed to provide evidence of long-term adherence to exercise or any meaningful effect on Quality of Life (QoL). We created a program of therapeutic education and a personalized program of reconditioning exercise for patients with PAD.
  
  
  METHODS
  Patients with an ankle-brachial index (ABI) below 0.9 in at least one limb, and an absolute claudication distance (ACD) ≤500 meters, were included in the study. Quality of Life (QoL) as measured by SF-36, cardiovascular risk factors and functional parameters were evaluated at 0, 3, 6 and 12 months.
  
  
  RESULTS
  Forty-six patients completed the program. Cardiovascular risks were controlled and stabilized over time. SF-36 scores improved significantly and remained stable. Initial and absolute claudication distance (ICD and ACD) as well as other functional parameters improved significantly (6 months: +138 m or +203% ICD and +139 m or +84% ACD). Ten patients (22%) did not show improvement in ICD or ACD within the first 3 months, but their SF-36 score did increase at subsequent visits. Interestingly, these patients had a significantly lower ACD at baseline.
  
  
  CONCLUSIONS
  This study measured beneficial effects of an educational therapeutic program for patients with PAD. The results demonstrate a significant improvement in functional and QoL parameters during the first 3 months of coaching, and long-term persistence of the results even when patients were no longer coached.
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, Hôpital Cardiologique, Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Prévost
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, Hôpital Cardiologique, Bordeaux, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Lafitte
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, Hôpital Cardiologique, Bordeaux, France.
authors.forename: Yann
authors.initials: Y
authors.lastname: Pucheu
authors.affiliation: CHU de Bordeaux, Centre d'Exploration, de Prévention et de Traitement de l'Athéroclérose, Hôpital Cardiologique, Bordeaux, France Univ. Bordeaux, Adaptation cardiovasculaire à l'ischémie, Pessac, France INSERM, Adaptation cardiovasculaire à l'ischémie, Pessac, France thierry.couffinhal@u-bordeaux2.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: Couffinhal
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005602:France; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D055502:Secondary Prevention / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: (QoL); Peripheral artery disease; Quality of Life; cardiovascular risks; exercise programs; therapeutic education