title: Comparing Supervised Exercise Therapy to Invasive Measures in the Management of Symptomatic Peripheral Arterial Disease.
abstract: Peripheral arterial disease (PAD) is associated with considerable morbidity and mortality. Consensus rightly demands the incorporation of supervised exercise training (SET) into PAD treatment protocols. However, the exact role of SET particularly its relationship with intervention requires further clarification. While supervised exercise is undoubtedly an excellent tool in the conservative management of mild PAD its use in more advanced disease as an adjunct to open or endovascular intervention is not clearly defined. Indeed its use in isolation in this cohort is incompletely reported. The aim of this review is to clarify the exact role of SET in the management of symptomatic PAD and in particular to assess its role in comparison with or as an adjunct to invasive intervention. A systematic literature search revealed a total 11 randomised studies inclusive of 969 patients. All studies compared SET and intervention with monotherapy. Study results suggest that exercise is a complication-free treatment. Furthermore, it appears to offer significant improvements in patients walk distances with a combination of both SET and intervention offering a superior walking outcome to monotherapy in those requiring invasive measures.
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Aherne
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Seamus
authors.initials: S
authors.lastname: McHugh
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Elrasheid A
authors.initials: EA
authors.lastname: Kheirelseid
authors.affiliation: Department of Interventional Radiology, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Human and Health Performance, Dublin City University, Dublin 9, Ireland.
authors.forename: Noel
authors.initials: N
authors.lastname: McCaffrey
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Daragh
authors.initials: D
authors.lastname: Moneley
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Austin L
authors.initials: AL
authors.lastname: Leahy
authors.affiliation: Department of Vascular Surgery, Beaumont Hospital, Dublin 9, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Naughton