Supervised exercise therapy is a commonly prescribed treatment for peripheral artery disease, improving both quality of life and functional capacity. But after exercise therapy ends, do these gains disappear?
Peripheral artery disease is a common condition that is often associated with considerable pain, reduced physical function, and diminished quality of life. Commonly characterized by muscle pain during walking (“intermittent claudication”), it is a chronic and progressive disease caused by a restriction of peripheral arteries in the legs. This leads to reduced blood perfusion and long-term complications including ulceration and gangrene. Treatment for peripheral artery disease typically involves pharmacological interventions to address any underlying atherosclerosis, lifestyle modifications, and supervised exercise therapy. Supervised exercise therapy has been shown to decrease pain and improve walking distance, in part by promoting increased efficiency of oxygen utilization in the affected muscles.
While supervised exercise programs work, are the gains made with them maintained long after cessation of the program? A new paper in the Journal of Disability and Rehabilitation (Guidon, M., and McGee, H. One-year effect of a supervised exercise programme on functional capacity and quality of life in peripheral arterial disease. Disabil Rehabil. 2012 Jul 19 Epub ahead of print) examined patients enrolled in a 12 week supervised exercise program to answer this question. As expected, patients receiving exercise therapy experienced improvements in functional capacity and quality of life that exceeded patients who did not receive exercise therapy. Importantly, at a one year follow-up these benefits were shown to be maintained, with both greater functional capacity and greater quality of life reported in patients who had previously received exercise therapy.
Although this result is not altogether surprising to rehabilitation specialists with experience working with peripheral arterial disease, it is heartening to see empirical evidence of longer-term maintenance of rehabilitation gains. Working at Toronto Physiotherapy I’ve seen first-hand that exercise-induced soft-tissue adaptation is a powerful rehabilitation tool for a variety of conditions, but it is also a double-edged sword. If the underlying issue is not managed, or an appropriate maintenance plan not put in place, a return of symptoms may be inevitable.