Exercise training for intermittent claudication.
Exercise training for intermittent claudication.
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DOI：
10.1016/j.jvs.2017.05.111
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发表时间：
2017-11
影响因子：
4.3
通讯作者：
McDermott MM
中科院分区：
文献类型：
--
作者：
McDermott MM
概述下肢外周动脉疾病患者运动疗法的证据。这份手稿总结了作为2016年克劳福德关键问题研讨会的一部分所发表的演讲的内容。多项随机临床试验表明，有监督的跑步机运动可显著改善PAD和间歇性跛行症状患者的跑步机行走能力。对25项随机试验的荟萃分析表明，与非运动对照组相比，监督跑步机运动干预的跑步机步行距离增加了180米。由于缺乏医疗保险，许多PAD患者无法接受有监督的跑步机锻炼。然而，在2017年，医疗补助和医疗保险服务中心发布了一份拟议的决定备忘录，以支持健康保险覆盖12周的监督跑步机运动，用于因PAD而导致行走障碍的患者。最近的证据也支持以家庭为基础的步行锻炼，以改善PAD患者的步行表现。有效的家庭锻炼计划包括行为改变干预，如远程教练，目标设定和自我监控。有监督的跑步机锻炼计划优先改善跑步机步行表现，而基于家庭的步行锻炼计划优先改善走廊步行，例如六分钟步行测试。临床试验证据也支持手臂或腿部测力计运动，以提高PAD患者的步行耐力。跑步机步行锻炼在提高步行耐力方面上级单独的阻力训练。与不运动相比，有监督的跑步机运动可显着提高患有PAD的人的跑步机步行能力约180米。最近的证据表明，在家锻炼也是有效的，并且优先改善地面步行性能，例如六分钟步行测试。
To provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease. This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. Multiple randomized clinical trials demonstrate that supervised treadmill exercise significantly improves treadmill walking performance in people with PAD and intermittent claudication symptoms. A meta-analysis of 25 randomized trials demonstrated a 180 meter increase in treadmill walking distance in response to supervised treadmill exercise interventions, compared to a non-exercising control group. Supervised treadmill exercise has been inaccessible to many patients with PAD because of lack of medical insurance coverage. However, in 2017 the Centers for Medicaid and Medicare Service issued a proposed decision memorandum to support health insurance coverage of 12 weeks of supervised treadmill exercise for patients with walking impairment due to PAD. Recent evidence also supports home-based walking exercise to improve walking performance in people with PAD. Effective home-exercise programs incorporate behavioral change interventions such as a remote coach, goal setting, and self-monitoring. Supervised treadmill exercise programs preferentially improve treadmill walking performance, while home-based walking exercise programs preferentially improve corridor walking, such as the six-minute walk test. Clinical trial evidence also supports arm or leg ergometry exercise to improve walking endurance in people with PAD. Treadmill walking exercise appears superior to resistance training alone for improving walking endurance. Supervised treadmill exercise significantly improves treadmill walking performance in people with PAD by approximately 180 meters, compared to no exercise. Recent evidence suggests that home-based exercise is also effective, and preferentially improves over ground walking performance, such as the six-minute walk test.
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影响因子：
5.4
作者：
Gardner AW;Parker DE;Montgomery PS;Blevins SM
通讯作者：
Blevins SM
影响因子：
24
作者：
McDermott, Mary M.;Guralnik, Jack M.;Criqui, Michael H.
通讯作者：
Criqui, Michael H.
影响因子：
4.3
作者：
Bronas, Ulf Gunnar;Treat-Jacobson, Diane;Leon, Arthur S.
通讯作者：
Leon, Arthur S.
影响因子：
4.3
作者：
Conte, Michael S.;Pomposelli, Frank B.;Sidawy, Anton N.
通讯作者：
Sidawy, Anton N.
影响因子：
168.9
作者：
Fowkes, F. Gerald R.;Rudan, Diana;Criqui, Michael H.
通讯作者：
Criqui, Michael H.