Effects of a 12-week Supervised Rehabilitation Exercise Program on Patients With Peripheral Artery Disease With or At Risk of Lower Limb Wound: A Retrospective Cohort Study.

Abstract

Objective: The aim of this study was to describe a cohort of patients participating in a 12-week supervised exercise program as part of a comprehensive cardiovascular rehabilitation program for patients with peripheral artery disease (PAD) with or at risk of wound on maximal walking distance, wound healing, and cardiovascular outcomes in the year following participation.

Methods: A retrospective cohort study was conducted, and all adult patients with PAD admitted to the rehabilitation program between January 1, 2021, and January 1, 2023 were included.

Results: Forty-two patients with PAD were enrolled, of whom 85.7% had intermittent claudication and 38.1% had severe PAD (toe pressure measurement <30 mm Hg). Mean maximal walking distance at the 6-minute walking test was 301.8 m (median: 300.0, SD: 106.3) at baseline and increased to 408.3 m (median: 440, SD: 123.8) at the end of the program. All patients with a wound at baseline (n = 8) were healed, except for 1 patient who died before healing. One year following the program, only 1 patient developed a new wound, 4 benefited from a percutaneous angioplasty, none required a surgical revascularization, and 1 had a major lower limb amputation.

Conclusions: A 12-week supervised exercise program appears beneficial to improve walking distance for patients with moderate to severe PAD. It also appears safe for patients with or at risk of a lower limb wound, providing tailored exercises prespecified for each patient and adequate supervision. However, prospective studies are required before making clinical recommendations of such a program for the at-risk foot with PAD.