Next Article in Journal
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients
Previous Article in Journal
The Optimal Indication for Testosterone Replacement Therapy in Late Onset Hypogonadism
Article Menu
Issue 2 (February) cover image

Export Article

Open AccessArticle
J. Clin. Med. 2019, 8(2), 210; https://doi.org/10.3390/jcm8020210

Rehabilitative Exercise Reduced the Impact of Peripheral Artery Disease on Vascular Outcomes in Elderly Patients with Claudication: A Three-Year Single Center Retrospective Study

1
Department of Biomedical and Surgical Specialties Sciences, University of Ferrara, 44121 Ferrara, Italy
2
Unit of Physical and Rehabilitation Medicine, University Hospital of Ferrara, 44121 Ferrara, Italy
3
Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), University of Cordoba, Reina Sofía University Hospital, 14004 Cordoba, Spain
4
Department of Medical Statistics, University Hospital of Ferrara, 44124 Ferrara, Italy
5
Unit of Vascular and Endovascular Surgery, University Hospital of Ferrara, 44124 Ferrara, Italy
6
Unit of Translational Surgery, University Hospital of Ferrara, 44124 Ferrara, Italy
7
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
*
Author to whom correspondence should be addressed.
Received: 10 January 2019 / Revised: 4 February 2019 / Accepted: 6 February 2019 / Published: 7 February 2019
(This article belongs to the Section Vascular Medicine)
Full-Text   |   PDF [1375 KB, uploaded 18 February 2019]   |  

Abstract

The study retrospectively evaluated the association between rehabilitative outcomes and risk of peripheral revascularizations in elderly peripheral artery disease (PAD) patients with claudication. Eight-hundred thirty-five patients were enrolled. Ankle-brachial index (ABI) and maximal walking speed (Smax) were measured at baseline and at discharge from a structured home-based rehabilitation program. For the analysis, patients were divided according to a baseline ABI value (severe: ≤0.5; moderate: ≥0.5) and according to hemodynamic or functional rehabilitative response (responder: ABI ≥ 0.10 and/or Smax > 0.5 km/h). Three-year outcomes were collected from the regional registry. According to the inclusion criteria (age 60–80, ABI < 0.80; program completion) 457 patients, 146 severe and 311 moderate, were studied. The whole population showed significant functional and hemodynamic improvements at discharge, with 56 revascularizations and 69 deaths at follow-up. Compared to the moderate group, the severe group showed a higher rate of revascularizations (17% vs. 10%, p < 0.001) and deaths (29% and 8%, respectively; p < 0.001). However, patients with severe PAD who were ABI responders after rehabilitation showed less revascularizations than non-responders (13% vs. 21%; hazard ratio (HR): 0.52) and were not different from patients with moderate disease (9%). Superimposable rates were observed for Smax responders (13% vs. 21%; HR: 0.55; moderate 10%). In conclusion, elderly patients with severe PAD empowered by better rehabilitation outcomes showed lower rates of peripheral revascularizations and deaths that were comparable to patients with moderate PAD. View Full-Text
Keywords: mortality; exercise; peripheral artery disease; rehabilitation; vascular surgical procedures mortality; exercise; peripheral artery disease; rehabilitation; vascular surgical procedures
Figures

Figure 1

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

Supplementary material

SciFeed

Share & Cite This Article

MDPI and ACS Style

Manfredini, F.; Lamberti, N.; Guerzoni, F.; Napoli, N.; Gasbarro, V.; Zamboni, P.; Mascoli, F.; Manfredini, R.; Basaglia, N.; Rodríguez-Borrego, M.A.; López-Soto, P.J. Rehabilitative Exercise Reduced the Impact of Peripheral Artery Disease on Vascular Outcomes in Elderly Patients with Claudication: A Three-Year Single Center Retrospective Study. J. Clin. Med. 2019, 8, 210.

Show more citation formats Show less citations formats

Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Related Articles

Article Metrics

Article Access Statistics

1

Comments

[Return to top]
J. Clin. Med. EISSN 2077-0383 Published by MDPI AG, Basel, Switzerland RSS E-Mail Table of Contents Alert
Back to Top