Fakhry F, Spronk S, de Ridder M, den Hoed PT, Hunink MGM. Long-term effects of structured home-based exercise program on functional capacity and quality of life in patients with intermittent claudication. Objectives: To evaluate effects of a structured home-based exercise program on functional capacity and quality of life (QoL) in patients with intermittent claudication (IC) after 1-year follow-up, and to compare these results with those from a concurrent control group who received supervised exercise training (SET). Design: Comparative longitudinal cohort study. Setting: Referral center. Participants: Patients (N=142) with IC. Interventions: Structured home-based exercise training or SET. Main Outcome Measures: The maximum (pain-free) walking distance and the ankle-brachial index (ABI) (at rest and postexercise) were measured at baseline and after 6 and 12 months' follow-up. Additionally, QoL was evaluated using a self-administered questionnaire consisting of the Euroqol-5D (scale 01), rating scale (scale 0100), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36; scale 0100), and the Vascular Quality of Life Questionnaire (VascuQol; scale 17). Comparison of the groups was performed with adjustment for the nonrandomized setting using propensity scoring. Results: One hundred forty-two patients with IC started the structured home-based exercise program, of whom 95 (67%) completed 12 months' follow-up. The mean relative improvement compared with baseline was statistically significant after 12 months' follow-up for the maximum and pain-free walking distance (342%, 95% confidence interval [CI], 169516; P<.01 and 338%, 95% CI, 42635; P=.03, respectively) and for the ABI postexercise (mean change, .06; 95% CI, .01.10; P=.02). For the QoL outcomes, the improvement compared with baseline was statistically significant after 12 months for the VascuQol (mean change, .42; 95% CI, .20.65; P<.01) and for the SF-36 physical functioning (mean change, 5.17; 95% CI, .779.56; P=.02). Compared with the structured home-based exercise program, patients in the control group showed significantly better results in the mean relative improvement of maximum and pain-free walking distance and change in the ABI at rest after 12 months' follow-up. Conclusions: Structured home-based exercise training is effective in improving both functional capacity and QoL in patients with IC and may be considered as a feasible and valuable alternative toSET, since supervised exercise programs are not often available.

Additional Metadata
Keywords Exercise, Intermittent claudication, Outcome assessment (health care), Peripheral arterial disease, Quality of life, Rehabilitation
Persistent URL dx.doi.org/10.1016/j.apmr.2011.02.007, hdl.handle.net/1765/26569
Citation
Fakhry, F, Spronk, S, de Ridder, M.A.J, den Hoed, P.Th, & Hunink, M.G.M. (2011). Long-term effects of structured home-based exercise program on functional capacity and quality of life in patients with intermittent claudication. Archives of Physical Medicine and Rehabilitation, 92(7), 1066–1073. doi:10.1016/j.apmr.2011.02.007