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The Role of Supervised Exercise Therapy in the Management of Symptomatic Peripheral Artery Disease with Intermittent Claudication

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Abstract

Purpose of review

This review highlights the latest progress and future directions for the role of supervised exercise therapy (SET) in the management of symptomatic peripheral artery disease (PAD) with intermittent claudication (IC).

Recent findings

SET is a cornerstone therapy to improve walking distance and functional status in symptomatic PAD patients with IC, but the low participation rate is a long-standing challenge. Recently, some pioneer studies have integrated SET into home-based exercise intervention (HBEI) with new technologies and clinical practice. For home-based walking exercise, the LITE trial reported that the high-intensity exercise improved walking distance compared to the low-intensity group. For home-based exercise behavioral change intervention, the results are modest. The MOSAIC trial reported that the intervention improved walking distance at the 3- but not 6-month follow-up. The BIP trial reported that the intervention did not significantly improve the step count. For integrating SET into clinical practice, the TELEX investigators reported that telmisartan did not improve walking distance on top of SET.

Summary

Functional improvement in symptomatic PAD with IC remains a challenge. The recent novel findings may pave a multidisciplinary way to maximize benefits and to minimize risks of SET, via integrating SET into HBEI and clinical practice. Further studies are warranted to explore the mechanism and long-term outcomes of SET in the management of symptomatic PAD patients.

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  1. Fang-Qin Wu and Qian-Wan Deng contributed equally as co-first authors.

Authors and Affiliations

  1. Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China

    Fang-Qin Wu MD, PhD

  2. Department of Cardiovascular Medicine, Translational Research Laboratory for Vascular Integrative Medicine, Shanghai Institute of Hypertension, National Key Laboratory of Medical Genomics, National Research Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Qian-Wan Deng MD, Ji-Guang Wang MD, PhD & Wen-Zhu Li MD

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Fang-Qin has no conflicts of interest to disclose relevant to this paper. Qian-Wan Deng has no conflicts of interest to disclose relevant to this paper. Ji-Guang Wang has no conflicts of interest to disclose relevant to this paper. Wen-Zhu Li has no conflicts of interest to disclose relevant to this paper.

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Wu, FQ., Deng, QW., Wang, JG. et al. The Role of Supervised Exercise Therapy in the Management of Symptomatic Peripheral Artery Disease with Intermittent Claudication. Curr Treat Options Cardio Med 25, 501–513 (2023). https://doi.org/10.1007/s11936-023-01001-7

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