Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series.

Abstract

OBJECTIVES:

To assess feasibility and effect of multimodal prehabilitation in patients with severe life-limiting intermittent claudication and complex infrainguinal disease.

DESIGN:

Case series of patients who underwent a 12-week prehabilitation program.

SETTING:

Outpatient clinic of a public tertiary hospital.

PARTICIPANTS:

Patients with a diagnosis of severe life-limiting intermittent claudication (Fontaine stage IIb and III) with complex infrainguinal disease or previous failed bypass attempts (N=5) who were referred to the prehabilitation clinic by a vascular surgeon.

INTERVENTIONS:

Patients underwent a baseline assessment that included quality of life questionnaires and functional capacity tests. After baseline assessment, they received a 12-week prehabilitation program that consisted of (1) a supervised exercise session 1 time per week; (2) home-based exercise prescription; (3) nutritional counseling; (4) smoking cessation; and (5) psychosocial intervention. Adherence to all components was recorded as well as the occurrence of any adverse event. After completion of the 12-week program, patients were reassessed.

MAIN OUTCOME MEASURE:

Feasibility of prehabilitation measured by adherence to the different components of the program and occurrence of adverse events.

RESULTS:

All 5 patients completed the program. No serious adverse events occurred during the length of prehabiliation. Median adherence to each prehabilitation component was 91.7% (interquartile range [IQR], 33.5%) for supervised training, 91.7% (IQR, 40%) for home-based exercise, and 75% (IQR, 50%) for nutrition. Three of the 5 patients underwent psychosocial intervention and all who were active smokers enrolled in the smoking cessation program. Functional capacity measured with the 6-minute walk distance improved by 70 m (IQR, 99 m), and disease-specific quality of life measured with the Vascular Quality of Life Questionnaire improved by 25%.

CONCLUSION:

Multimodal prehabilitation appears to be a feasible tool that could be used to increase functional capacity and quality of life for patients with complex infrainguinal disease and expected poor revascularization outcome or previous failed bypass attempts.

• Authors: Miquel Coca-Martinez, Francesco Carli, Heather L Gill
• Journal: Archives of rehabilitation research and clinical translation (Arch Rehabil Res Clin Transl) Vol. 3 Issue 3 Pg. 100139 (Sep 2021) ISSN: 2590-1095 [Electronic] United States
• PMID: 34589689 (Publication Type: Journal Article, Review)
• Copyright: © 2021 The Authors.