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Tunc Tuna P, Tuna HI, Molu B, Yildirim Keskin A. Factors Affecting Postoperative Pain Beliefs Among Surgical Patients in Türkiye: A Cross-Sectional Study. Pain Manag Nurs 2024; 25:e265-e270. [PMID: 38461043 DOI: 10.1016/j.pmn.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Frequency, ability to cope, and severity of pain; the genetic structure of the individual affects their emotional and cultural characteristics, beliefs, and personal characteristics. It is stated that pain beliefs are one of the factors affecting emotional pain control and approach to pain. AIMS This study, it is aimed to determine the pain beliefs of individuals experiencing postoperative pain. METHODS Cross-sectional descriptive study. Surgical services of a single secondary care hospital. 170 patients who were in the first week after surgery, experienced acute pain, were between the ages of 18-65, and did not have a psychiatric disorder were evaluated. Collection Tools: Postoperative pain levels of the patients were evaluated with a Visual Analog Scale. As the VAS score increases, the pain level increases. Pain beliefs were evaluated with the Pain Beliefs Scale. Pain Beliefs Scale increases in the score obtained from the sub-score of the scale indicate that the pain beliefs related to that test are high. A student T-Test was used for bivariate comparisons between groups. One-way ANOVA was used to compare trivariate groups. In addition, Spearman's Correlation analysis was performed. Statistically, a confidence interval of >95% was used. The statistical significance level was set as p < 0.05. RESULTS It was found that the pain levels of the patients participating in the study were low and the scores they received from the Pain Beliefs Scale subscales were moderate. It was determined that those with lower education levels had higher scale scores in the psychological beliefs sub-dimension of the Pain Beliefs Scale. In the organic beliefs sub-dimension, it was determined that those with lower income levels had higher organic beliefs. It was determined that the postoperative pain experienced did not affect pain beliefs (p > 0.05). CONCLUSION It was concluded that there was no relationship between the pain level and pain beliefs of patients with low pain in the postoperative period. Individuals experiencing postoperative pain believe that pain occurs due to the influence of both organic and psychological factors. For this reason, it is recommended factors that nurses who care for individuals experiencing postoperative pain provide care for both organic and psychological sources of pain.
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Affiliation(s)
| | | | - Birsel Molu
- Department of Nursing, Selcuk University, Konya, Turkey
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Mizner RL, Mays AA, Mays RJ. Mechanical adaptations in walking using carbon fiber ankle foot orthoses for patients with peripheral artery disease. Gait Posture 2023; 101:14-20. [PMID: 36696821 PMCID: PMC10023472 DOI: 10.1016/j.gaitpost.2023.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND The effectiveness of community-based walking programs for patients with peripheral artery disease (PAD) can be limited by calf claudication during exercise. Recent evidence finds adding carbon fiber ankle foot orthoses (AFO) to a walking program can result in improvements in patient mobility and delay claudication onset when walking. RESEARCH QUESTION How may carbon fiber AFO alter ankle walking mechanics and corresponding triceps surae muscle recruitment in a manner that could improve patient mobility? METHODS In this repeated measures cohort study, fifteen patients with PAD were fit with bilateral AFO before completing self-paced gait analysis including electromyography. Patients were then given standard advice to walk at home using the devices for 12 weeks. Twelve patients completed follow-up testing. RESULTS There were no significant interactions between main effects for any variable of interest (p ≥ 0.189). Further, there were no within-subjects main effects for testing time for self-selected gait speed or any of the kinetic or kinematic variables (p ≥ 0.435). There were significant main effects for AFO use with reductions in dorsi flexion (p < 0.001), plantar flexion at toe off (p < 0.001), ankle plantar flexor moment (p = 0.037), and ankle plantar flexor power (p < 0.001). Triceps surae recruitment did not change between AFO conditions (p > 0.05). SIGNIFICANCE Adding carbon fiber AFO limits peak ankle motion and joint power during self-paced walking for people with PAD while maintaining their walking speed. These gait adaptions were maintained over our 12 weeks of walking practice time. A resulting decrease in plantar flexor power while maintaining gait speed may provide the mechanism by which AFO can delay claudication onset which are major barrier to PAD walking programs. Calf muscle recruitment was maintained when adding the AFO which suggests sufficient muscle exertion could exist to maintain muscle integrity with sustained AFO use.
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Affiliation(s)
- Ryan L Mizner
- University of Montana, School of Physical Therapy and Rehabilitation Science, Missoula, MT, United States.
| | - Ashley A Mays
- North Memorial Medical Center, Heart and Vascular Center, Robbinsdale, MN, United States
| | - Ryan J Mays
- University of Minnesota, School of Nursing, Adult and Gerontological Health Cooperative, Minneapolis, MN, United States
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Güneş M, Özmen T, Güler TM. The association between pain, balance, fall, and disability in patients with lumbar spinal stenosis with vascular claudication. Korean J Pain 2021; 34:471-478. [PMID: 34593665 PMCID: PMC8494951 DOI: 10.3344/kjp.2021.34.4.471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/29/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023] Open
Abstract
Background The effect of lumbar spinal stenosis (LSS) and peripheral vascular disease (PVD), which occurs with similar degenerative conditions, when seen together, has not been studied. The aim of this study is to examine and compare the relationship between pain, balance, disability, fear of falling, and kinesiophobia in LSS patients with intermittent vascular claudication (IVC). Methods Seventy-two patients diagnosed with LSS using magnetic resonance imaging participated in this study. Thirty-five patients with IVC symptoms and showing vascular lesions by lower extremity venous and arterial Doppler ultrasonography imaging were included in the IVC-LSS group. The pain, static balance, dynamic balance, disability, fear of falling, and kinesiophobia were evaluated using the numeric rating scale, single leg stance test, Time Up and Go (TUG), the Oswestry Disability Index (ODI), Fall Efficacy Scale-International (FES-I), and Tampa Scale for Kinesiophobia (TSK), respectively. Results Age and female sex were found to be higher in the IVC-LSS group (P = 0.024; P = 0.012). The IVC-LSS group had a shorter single leg stance time and TUG test duration, pain intensity, ODI, FES-I, and TSK scores were higher than patients with LSS (P = 0.001). Pain, fear of falling, and kinesiophobia were moderately correlated with disability in the IVC-LSS group. No relationship was found between pain and dynamic balance. Also, the pain was not related to kinesiophobia. Conclusions The findings indicated that IVC causes loss of balance and an increase in pain, disability, fear of falling, and kinesophobia in patients with LSS.
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Affiliation(s)
- Musa Güneş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Tarık Özmen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Karabuk University, Karabuk, Turkey
| | - Tuğba Moralı Güler
- Department of Neurosurgery, Faculty of Medicine, Karabuk University, Karabuk, Turkey
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Cornelis N, Buys R, Dewit T, Benoit D, Claes J, Fourneau I, Cornelissen V. Satisfaction and Acceptability of Telemonitored Home-Based Exercise in Patients With Intermittent Claudication: Pragmatic Observational Pilot Study. JMIR Rehabil Assist Technol 2021; 8:e18739. [PMID: 33749616 PMCID: PMC8108570 DOI: 10.2196/18739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/20/2020] [Accepted: 01/18/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Current guidelines recommend supervised exercise training (SET) as a first-line treatment in patients with intermittent claudication (IC). SET has been shown to be more effective than home-based exercise therapy (HBET). However, the lack of available SET programs hampers broad SET implementation in clinical practice. OBJECTIVE The aim of this study is to assess patient satisfaction and acceptability of a structured HBET program using wearable technology and elastic band resistance exercises. METHODS A total of 20 patients with IC (Rutherford 1-3) with internet access and currently not engaged in structured exercise training were recruited in a pragmatic observational pilot study. Participants were instructed to complete 3 walking sessions and 2 elastic band resistance exercise sessions per week in their home environment during a 4-week period. Patient satisfaction and acceptability were assessed using a 5-point Likert scale questionnaire (1-2=very unsatisfied, 3=neutral, and 4-5=very satisfied) evaluating the materials and intervention content. Secondary outcomes were evaluated at baseline and at completion of the 4-week intervention and included maximal walking distance (MWD) and pain-free walking distance (PFWD), physical fitness, and patient-reported outcomes on quality of life, walking capacity, levels of kinesiophobia, and self-efficacy. Statistically significant changes were tested using paired t tests or Wilcoxon signed-rank tests. RESULTS All patients (15 men, 5 women; mean age 64.6, SD 10.6 years; range 41-81 years) completed the 4-week intervention and were highly satisfied with the program (mean overall score 4.5, SD 0.5). Patients' questionnaire responses documented willingness to recommend the exercise program to other patients (mean 4.5, SD 0.5; median 4.5) and preference for continuing the intervention (mean 4.3, SD 0.5; median 4). Furthermore, participants endorsed the use of the sports watches to track walking sessions (mean 4.25, SD 0.6; median 4), felt safe (mean 4.4, SD 0.6; median 4), and appreciated personal feedback (mean 4.55, SD 0.5; median 5) and flexibility of training (mean 4.1, SD 0.7; median 4). Resistance training was not preferred over walking training (mean 2.65, SD 0.8; median 3). In addition, PFWD (+89 m; P=.001), MWD (+58 m; P=.03), Walking Impairment Questionnaire distance score (+0.18; P=.01), activity-related scores (+0.54; P<.001), and total quality of life (+0.36; P=.009) improved following the intervention. Other patient-related outcomes, physical fitness, and physical activity remained to be statistically unaltered. CONCLUSIONS Patients with IC were satisfied and accepted technology to monitor and guide HBET, with observed short-term effectiveness regarding walking capacity and quality of life. However, elastic band resistance exercises as a part of HBET were not preferred over progressive walking. TRIAL REGISTRATION ClinicalTrials.gov NCT04043546; https://clinicaltrials.gov/ct2/show/NCT04043546.
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Affiliation(s)
- Nils Cornelis
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
| | - Roselien Buys
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
| | - Tijl Dewit
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
| | - Dries Benoit
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
| | - Jomme Claes
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
| | - Inge Fourneau
- Department of Cardiovascular Sciences, Vascular Surgery, KU Leuven, Leuven, Belgium
| | - Véronique Cornelissen
- Department of Rehabilitation Sciences, Group Rehabilitation for Internal Disorders, KU Leuven, Leuven, Belgium
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Choma EA, Mays RJ, Mizner RL, Santasier AM. Patient perspectives of ankle-foot orthoses for walking ability in peripheral artery disease: A qualitative study. JOURNAL OF VASCULAR NURSING 2020; 38:100-107. [PMID: 32950110 DOI: 10.1016/j.jvn.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 06/20/2020] [Accepted: 07/21/2020] [Indexed: 12/31/2022]
Abstract
Calf claudication associated with peripheral artery disease results in limited walking ability and diminished quality of life. Ankle-foot orthoses (AFO) have been used to mitigate calf pain during community-based walking exercise, yet little is known about patients' perspectives of this novel device. The purpose of this qualitative study was to determine the personal impact AFO had on patients who used them. Ten patients with calf claudication who previously completed a 12-week unstructured community-based walking program supplemented by AFO participated in a semi-structured recorded focus group. After data saturation was achieved, transcripts were coded and analyzed, and 2 primary themes emerged from the focus groups: 1) positive functional impact of AFO on walking ability and quality of life and 2) self-selected AFO usage patterns. Six subthemes included 1) positive ambulatory changes from using AFO, 2) sustained ambulatory improvements without AFO, 3) positive psychosocial impact, 4) optimal conditions for AFO usage, 5) optimal ambulatory surfaces when using AFO, and 6) challenges with comorbidities. The AFO were influential in decreasing claudication symptoms, improving walking capacity, and enhancing participation in meaningful daily and recreational activities. This study explores experiential knowledge of patients with calf claudication describing AFO as an effective tool to enhance unstructured walking programs. Further trials are needed to optimize device design and effectiveness in varying walking environments.
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Affiliation(s)
- Elizabeth A Choma
- Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, Minnesota.
| | - Ryan J Mays
- Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, Minnesota
| | - Ryan L Mizner
- School of Physical Therapy and Rehabilitation Science, College of Health Professions and Biomedical Sciences, University of Montana, Missoula, Montana
| | - Anita M Santasier
- School of Physical Therapy and Rehabilitation Science, College of Health Professions and Biomedical Sciences, University of Montana, Missoula, Montana
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Sheng XF. Correlation of sleep quality with sleep belief and attitude in 120 elderly patients with chronic functional constipation. Shijie Huaren Xiaohua Zazhi 2020; 28:384-388. [DOI: 10.11569/wcjd.v28.i10.384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The change of living standard has changed the life style of the elderly. Chronic functional constipation (FC) seriously affects the health of the elderly and their sleep quality. The proposal of the brain-gut axis theory has attracted much attention from medical researchers. This study investigated the correlation between sleep quality and sleep cognition in elderly FC patients, with an aim to provide an objective basis for clinical use of targeted and precise cognitive behavioral intervention measures.
AIM To explore the correlation of sleep quality with sleep belief and attitude in elderly patients with chronic FC.
METHODS One hundred and twenty chronic FC elderly patients treated from July 2017 to July 2019 at the Second Hospital of Jinhua City, Zhejiang Province were selected as study subjects. The Pittsburgh sleep quality index (PSQI) scale and the dysfunctional beliefs and attitudes about sleep scale-16 (DBAS-16) were used to assess the sleep quality and sleep belief and attitude, respectively. Pearson correlation analysis was performed to assess the correlation of sleep quality with sleep belief and attitude.
RESULTS Compared with normal people, the sleep latency, sleep time, sleep efficiency, sleep disorder, daytime function, and total PSQI score of elderly FC patients all increased significantly (P < 0.05), while the scores of sleep quality and use of hypnotic drugs were all significantly lower (P < 0.05). The total DBAS-16 score of elderly FC patients was 48.12 ± 8.69, and the scores of the consequences of insomnia, sleep anxiety, sleep expectation, and drugs were 12.96 ± 4.98, 18.95 ± 5.12, 4.49 ± 2.36, and 10.36 ± 3.12, respectively. The consequences of insomnia were negatively correlated with sleep disorders and daytime function (r = -0.131 and -0.135, respectively). Sleep anxiety was negatively correlated with sleep quality, sleep latency, sleep time, sleep efficiency, hypnotic drugs, daytime function, and total PSQI score (r = -0.359, -0.228, -0.312, -0.224, -0.152, -0.221, and -0.376, respectively). Sleep expectation was negatively correlated with sleep efficiency and daytime function (r = -0.103 and -0.153, respectively). There was a negative correlation between drugs and sleep quality, sleep latency, sleep time, hypnotic drugs, and PSQI total score (r = -0.167, -0.142, -0.119, -0.434, and -0.211, respectively). The total DBAS-16 score was negatively correlated with the seven dimensions of sleep disorders and the total score of PSQI.
CONCLUSION The sleep quality of elderly patients with chronic FC is correlated with their sleep belief and attitude. Medical workers should enhance the awareness of sleep belief and attitude among elderly FC patients to improve sleep cognition and quality.
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Affiliation(s)
- Xue-Fen Sheng
- Second Hospital of Jinhua City, Jinhua 321000, Zhejiang Province, China
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Eyholzer S, Perrenoud B, Dwyer AA. Patient perceptions of peripheral artery disease: A cross-sectional study of hospitalized adults. JOURNAL OF VASCULAR NURSING 2019; 37:188-193. [PMID: 31727310 DOI: 10.1016/j.jvn.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/16/2022]
Abstract
Patients with peripheral artery disease (PAD) have increased risk for complications of cardiovascular disease. Smoking cessation, physical activity, and adherence to treatment are critical for limiting the progression of this chronic disease and improving health-related quality of life in patients with PAD.The aim of the study was to explore patient perceptions of PAD and views on medication, tobacco use, and physical activity. This descriptive, cross-sectional study included patients with PAD admitted to a vascular surgery unit at a tertiary academic medical center (October 2017 to January 2018). Sociodemographic data and medical information were collected during hospitalization. Patients completed the Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Cigarette Dependence Scale. Additional questions examined physical activity. In total, 32 patients participated in the study. About half (16/30) were active smokers, whereas the remainder had smoked in the past. Only half of patients (16/32) considered smoking as contributing to PAD. Most patients (18/30) perceived PAD as a chronic problem, yet 8/30 (27%) considered PAD a rather acute illness. Patients reported significant cognitive and emotional consequences of PAD (mean 6.2 ± 1.8 and 8.3 ± 2.9, maximum score 10, respectively). They rated relatively low perceived personal control (mean 4.8 ± 2.8, maximum score 10) and weak beliefs about the necessity of medication (mean 12.5 ± 3.3, maximum score 25). Most patients (21/32) perceived physical activity as a protective factor for PAD. Patients perceive PAD as having significant impact on their life and report low levels of personal control in managing PAD. Understanding patient health beliefs may inform more tailored therapeutic education and health promoting interventions to limit disease progression.
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Affiliation(s)
- Sebastien Eyholzer
- University of Lausanne (UNIL), Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland.
| | - Béatrice Perrenoud
- University of Lausanne (UNIL), Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland; University Hospital of Lausanne (CHUV), Lausanne, Switzerland
| | - Andrew A Dwyer
- University of Lausanne (UNIL), Institute of Higher Education and Research in Healthcare, Lausanne, Switzerland; Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
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Thomas SG, Marzolini S, Lin E, Nguyen CH, Oh P. Peripheral Arterial Disease: Supervised Exercise Therapy Through Cardiac Rehabilitation. Clin Geriatr Med 2019; 35:527-537. [PMID: 31543183 DOI: 10.1016/j.cger.2019.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Peripheral arterial disease (PAD) is frequently underdiagnosed and undertreated. This review identifies specific subgroups within older adults more likely to develop PAD, and describes methods to diagnose PAD and provide evidence in support of systematic referral to cardiac rehabilitation programs to enhance successful comprehensive management. Clear evidence and guidelines support the routine use of supervised exercise therapy to improve function, reduce risk of cardiovascular morbidity and mortality, and enhance the success of endovascular interventions.
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Affiliation(s)
- Scott G Thomas
- Faculty of Kinesiology and Physical Education, Department of Exercise Sciences, University of Toronto, 55 Harbord Street, Toronto M5S 2W6, Canada.
| | - Susan Marzolini
- Cardiovascular Prevention and Rehabilitation Program, KITE, University Health Network, 347 Rumsey Road, Toronto M4G 1R7, Canada
| | - Edward Lin
- Cardiovascular Prevention and Rehabilitation Program, KITE, University Health Network, 347 Rumsey Road, Toronto M4G 1R7, Canada
| | - Cindy H Nguyen
- Faculty of Kinesiology and Physical Education, Department of Exercise Sciences, University of Toronto, 55 Harbord Street, Toronto M5S 2W6, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program, KITE, University Health Network, 347 Rumsey Road, Toronto M4G 1R7, Canada
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Antunes-Correa LM. Non-traditional exercises in rehabilitation programmes for symptomatic patients with peripheral artery disease. Eur J Prev Cardiol 2019; 26:1623-1624. [PMID: 31216869 DOI: 10.1177/2047487319856130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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10
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Lin E, Nguyen CH, Thomas SG. Completion and adherence rates to exercise interventions in intermittent claudication: Traditional exercise versus alternative exercise - a systematic review. Eur J Prev Cardiol 2019; 26:1625-1633. [PMID: 31216860 DOI: 10.1177/2047487319846997] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Intermittent claudication, defined as fatigue or pain in the legs while walking, is a common symptom in peripheral arterial disease. Although exercise effectively improves function and manages symptoms, adherence rates are not ideal. The high levels of pain experienced in traditional exercise programmes may explain the suboptimal adherence. Alternative modalities of exercise can elicit similar benefits to traditional walking exercise. The purpose of this systematic review was to compare completion and adherence rates of exercise programmes in traditional exercise interventions versus alternative exercise interventions among patients with intermittent claudication. DESIGN Systematic review. METHODS The electronic databases of Medline, SPORTDiscus and CINAHL were searched from the earliest records to March 2018. Search terms were based on 'peripheral artery disease' and 'exercise'. Studies were included if they involved structured exercise and explicitly reported the number of participants that commenced and completed the programme. RESULTS The search identified 6814 records based on inclusion criteria. Eighty-four full-text records were reviewed in further detail. Out of the 84 studies, there was a total of 122 separate exercise groups, with 64 groups of 'traditional walking exercise' and 58 groups of 'alternative exercise'. Completion and adherence rates for traditional exercise were 80.8% and 77.6%, respectively. Completion and adherence rates for alternative exercise were 86.6% and 85.5%, respectively. CONCLUSIONS The use of alternative modalities of exercise, which have been proved to be as effective as traditional exercise, may offer a solution to the poor participation and adherence rates to exercise in this population.
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Affiliation(s)
- Edward Lin
- Training and Performance Laboratory, University of Toronto, Canada.,KITE, Toronto Rehab-University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada
| | - Cindy H Nguyen
- Training and Performance Laboratory, University of Toronto, Canada.,KITE, Toronto Rehab-University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada
| | - Scott G Thomas
- Training and Performance Laboratory, University of Toronto, Canada.,KITE, Toronto Rehab-University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada
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Abstract
PURPOSE OF REVIEW This paper provides a concise update on the management of peripheral artery disease (PAD). RECENT FINDINGS PAD continues to denote a population at high risk for mortality but represents a threat for limb loss only when associated with foot ulcers, gangrene, or infections. Performing either angiogram or non-invasive testing for all patients with foot ulcers, gangrene, or foot infections will help increase the detection of PAD, and refined revascularization strategies may help optimize wound healing in this patient group. Structured exercise programs are becoming available to more patients with claudication as methods to improve adherence to community-based exercise programs will improve. Finally, ensuring more patients with PAD receive aspirin therapy and statins may improve long-term survival, while further research will help determine if adding newer antiplatelet or anticoagulant medications may reduce leg amputations in selected patients. Clinicians should have a low threshold to obtain an angiogram and to pursue revascularization in patients with foot ulcers, gangrene, or foot infections. In patients with claudication, clinicians should maximize the benefits derived from exercise therapy and medical management before offering percutaneous or surgical revascularization.
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Affiliation(s)
- Neal R Barshes
- Division of Vascular Surgery and Endovascular Therapy, Michael E. Debakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard (OCL 112),, Houston, TX, 77030, USA.
| | - Courtney L Grant
- Division of Vascular Surgery and Endovascular Therapy, Michael E. Debakey Department of Surgery, Baylor College of Medicine/Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard (OCL 112),, Houston, TX, 77030, USA
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12
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Abaraogu UO, Ezenwankwo EF, Dall PM, Seenan CA. Living a burdensome and demanding life: A qualitative systematic review of the patients experiences of peripheral arterial disease. PLoS One 2018; 13:e0207456. [PMID: 30440040 PMCID: PMC6237376 DOI: 10.1371/journal.pone.0207456] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 10/31/2018] [Indexed: 01/27/2023] Open
Abstract
Background Peripheral arterial disease (PAD) has a significant negative impact on the quality of life of individuals. Understanding the experiences of people living with PAD will be useful in developing comprehensive patient-centred secondary prevention therapies for this population. Aim The aim of this study is to identify first-hand accounts of patients’ experiences of living with PAD. Methods Six databases (CINALH, PsyclNFO, MEDLINE, AMED, EMBASE, Social citation index/Science citation index via Web of Science (WOS)) and reference lists of identified studies were searched until September 2017 (updated February 2018). Qualitative studies reporting patients’ account of living with PAD were eligible for inclusion. A framework thematic synthesis was implemented. Results Fourteen studies with 360 participants were included. Pain and walking limitation were recurrent among the varied symptom descriptions. Patients’ ignorance and trivialisation of symptoms contributed to delays in diagnosis. Inadequate engagement in disease understanding and treatment decisions meant patients had poor attitudes towards walking treatments and unrealistic expectations about surgery. Depending on symptom progression, patients battle with walking impairment, powerlessness, and loss of independence which were a source of burden to them. Lack of disease understanding is central through patients’ journey with PAD and, although they subsequently began adaptation to long term living with PAD, many worried about their future. Conclusions Disease understanding is vital across the illness trajectory in patients with PAD. Although certain experiences are common throughout patient journey, some might be unique to a particular stage (e.g. unrealistic expectation about surgery, or rationale of walking in spite of pain in a supervised exercise program). Given that PAD is an overarching construct ranging from the mildest form of intermittent claudication to severe critical limb ischemia with ulceration and gangrene, consideration of important patient constructs specific to each stage of the disease may enhance treatment success. Systematic review registration CRD42017070417.
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Affiliation(s)
- Ukachukwu Okoroafor Abaraogu
- University of Nigeria Department of Medical Rehabilitation, Enugu, Nigeria
- Glasgow Caledonian University School of Health and Life Sciences, Glasgow, United Kingdom
- * E-mail:
| | | | - Philippa Margaret Dall
- Glasgow Caledonian University School of Health and Life Sciences, Glasgow, United Kingdom
| | - Chris Andrew Seenan
- Glasgow Caledonian University School of Health and Life Sciences, Glasgow, United Kingdom
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Barriers and enablers to walking in individuals with intermittent claudication: A systematic review to conceptualize a relevant and patient-centered program. PLoS One 2018; 13:e0201095. [PMID: 30048501 PMCID: PMC6062088 DOI: 10.1371/journal.pone.0201095] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/09/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Walking limitation in patients with peripheral arterial disease (PAD) and intermittent claudication (IC) contributes to poorer disease outcomes. Identifying and examining barriers to walking may be an important step in developing a comprehensive patient-centered self-management intervention to promote walking in this population. AIM To systematically review the literature regarding barriers and enablers to walking exercise in individuals with IC. METHODS A systematic review was conducted utilizing integrative review methodology. Five electronic databases and the reference lists of relevant studies were searched. Findings were categorized into personal, walking activity related, and environmental barriers and enablers using a social cognitive framework. RESULTS Eighteen studies including quantitative (n = 12), qualitative (n = 5), and mixed method (n = 1) designs, and reporting data from a total of 4376 patients with IC, were included in the review. The most frequently reported barriers to engaging in walking were comorbid health concerns, walking induced pain, lack of knowledge (e.g. about the disease pathology and walking recommendations), and poor walking capacity. The most frequently reported enablers were cognitive coping strategies, good support systems, and receiving specific instructions to walk. Findings suggest additionally that wider behavioral and environmental obstacles should be addressed in a patient-centered self-management intervention. CONCLUSIONS This review has identified multidimensional factors influencing walking in patients with IC. Within the social cognitive framework, these factors fall within patient level factors (e.g. comorbid health concerns), walking related factors (e.g. claudication pain), and environmental factors (e.g. support systems). These factors are worth considering when developing self-management interventions to increase walking in patients with IC. Systematic review registration CRD42018070418.
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Preferred exercise modalities in patients with intermittent claudication. JOURNAL OF VASCULAR NURSING 2018; 36:81-84. [DOI: 10.1016/j.jvn.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 11/17/2022]
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Schorr EN, Mays RJ. Patient perspectives on claudication: An opportunity to improve the adoption and adherence of exercise therapy. Vasc Med 2017; 22:385-386. [PMID: 28795643 DOI: 10.1177/1358863x17724265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Erica N Schorr
- 1 Adult and Gerontological Health Cooperative, School of Nursing, Academic Health Center, University of Minnesota, Minneapolis, MN, USA
| | - Ryan J Mays
- 1 Adult and Gerontological Health Cooperative, School of Nursing, Academic Health Center, University of Minnesota, Minneapolis, MN, USA.,2 Division of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.,3 Center for Women's Health Research, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
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