title: The effect of supervised exercise therapy on physical activity and ambulatory activities in patients with intermittent claudication.
abstract: OBJECTIVE
  Intermittent claudication (IC) is associated with a reduction in physical activity (PA) and a more rapid functional decline leading to a higher mortality rate compared with healthy individuals. Supervised exercise therapy (SET) is known to increase the walking capacity of patients with IC. However, it is unclear whether SET increases PA. The aim of this study was to investigate the effect of SET on PA levels and ambulatory activities in patients with IC.
  
  
  METHODS
  Patients newly diagnosed with IC were requested to wear an activity monitor 1 week prior to and 1 week immediately after 3 months of SET. The primary outcome was the percentage of patients meeting the minimum recommendations of PA (American College of Sports Medicine [ACSM]/American Heart Association [AHA] recommendation for public health of ≥ 67 metabolic equivalents [METs]/min/day, in bouts of ≥ 10 min) at baseline and after 3 months of SET. Additionally, daily PA level (METs/min), duration of ambulatory activities, daily number of steps, pain free walking distance (PFWD), maximal walking distance (MWD), and Short Form Health Survey (SF-36) health surveys were compared before and after SET.
  
  
  RESULTS
  Data from 41 participants were available for analysis. A higher number of participants met the ACSM minimum recommendation for PA at the 3 month follow up (baseline: 43%; 3 months: 63%; p = .003). Despite significant increases in PFWD (baseline: 210 m; 3 months: 390 m; p = .001), MWD (baseline: 373 m; 3 months: 555 m; p = .002) and physical functioning score (SF-36) following SET, no increase in the mean daily PA level was found (395 ± 220 vs. 411 ± 228 METs/min; p = .43). Furthermore, the total number of steps and time spent in ambulatory activities did not change following SET.
  
  
  CONCLUSIONS
  Three months of SET for IC leads to more patients meeting the ACSM/AHA public health minimum recommendations for PA. Assessment of PA could be incorporated as an outcome parameter in future research comparing different treatment modalities for peripheral arterial disease.
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, P.O. Box 606, 6200 MD Maastricht, The Netherlands.
authors.forename: H J P
authors.initials: HJ
authors.lastname: Fokkenrood
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, P.O. Box 606, 6200 MD Maastricht, The Netherlands.
authors.forename: G J
authors.initials: GJ
authors.lastname: Lauret
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Verhofstad
authors.affiliation: Canisius Ziekenhuis, Department of Vascular Surgery, P.O. Box 9015, 6500 GS Nijmegen, The Netherlands.
authors.forename: B L W
authors.initials: BL
authors.lastname: Bendermacher
authors.affiliation: Maxima Medical Center, Department of Vascular Surgery, P.O. Box 7777, 5500 MB Veldhoven, The Netherlands; CARIM Research School, Maastricht University, P.O. Box 606, 6200 MD Maastricht, The Netherlands.
authors.forename: M R M
authors.initials: MR
authors.lastname: Scheltinga
authors.affiliation: Catharina Hospital, Department of Vascular Surgery, P.O. Box 1350, 5602 ZA Eindhoven, The Netherlands; CAPHRI Research School, Maastricht University, P.O. Box 606, 6200 MD Maastricht, The Netherlands. Electronic address: joep.teijink@catharinaziekenhuis.nl.
authors.forename: J A W
authors.initials: JA
authors.lastname: Teijink
mesh_terms: D056044:Actigraphy; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D015438:Health Behavior; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009426:Netherlands; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D057185:Sedentary Behavior; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
keywords: Activity monitor; Peripheral arterial disease; Physical activity; Supervised exercise