Supervisors info:
Κωνσταντίνος Δάβος, Ερευνητής Β, Ίδρυμα Ιατροβιολογικών ερευνών, Ακαδημία Αθηνών
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέτρος Μπακάκος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
The aim of current dissertation is to assess the effects of exercise and rehabilitation on patients with peripheral artery disease. Peripheral artery disease (PAD) or peripheral arterial obstructive disease (PAOD) is defined as the partial or complete occlusion of one or more of the arteries of the low extremities and is one of the three main manifestations of arteriosclerosis.
Given the increase in patients suffering from PAD, the improvement of prognosis by the use of modern treatment options and the frequent inadequacy of clinical laboratory criteria to stratify the real effect of the disease, quality of life assessment is a modern challenge for the physiotherapists and healthcare professionals.
In the present dissertation, a detailed report is of the disease is presented in order to understand its basic characteristics, based mainly on the cardiovascular complications it causes. In this context, risk factors, epidemiology, prognosis, diagnosis, etiology, clinical symptoms and treatment of the disease are analyzed.
Moreover, as detailed below, the range of systematic therapeutic exercise and physical rehabilitation is presented. This is a structured and multi-disciplinary intervention, which aims to reduce the risk of a new cardiovascular event, to acquire new lifestyle and habits, to increase patients' functional competence and promote physical activity in patients with PAD. Rehabilitation applies to both patients during and after PAD treatment. Some parameters that should be considered before the patient's daily mobilization will be also presented in the context of rehabilitation, as well as the indications for stopping an exercise session.
All the studies that were examined converge on walking exercise as the most effective intervention for patients with PAD. It is recommended treadmill walking in an exercise facility with an exercise physiologist, 3 times a week, with a session duration that begins at 15 minutes and gradually increases to 45-50 minutes, walking to near maximal or maximal ischemic leg pain and a program duration of 12 weeks at least. In case of inability attending a supervised treadmill exercise program, a home – based exercise program is recommended for patients with PAD, 3-5 times a week, with a session duration that begins at 10-15 minutes and gradually increases to 50 minutes, walking at self-selected pace and a program duration of 12 weeks to 6 months.
In conclusion, conservative treatment exclusively through physiotherapy intervention and exercise is not enough to limit the progression of the disease in cases of severe intermittent claudication (IC) or in cases of critical ischemia. However, it can be used successfully in the initial stages of the disease. Finally, the benefits of participating in therapeutic exercise programs are important, both for the patient and for society as a whole, because they can lead to a significant reduction in the health care cost.
