Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series
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 tertia...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-09-01
|
| Series: | Archives of Rehabilitation Research and Clinical Translation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109521000495 |
| _version_ | 1818908279483400192 |
|---|---|
| author | Miquel Coca-Martinez, MD, MSc Francesco Carli, MD, MPhil Heather L. Gill, MCMD, MPH |
| author_facet | Miquel Coca-Martinez, MD, MSc Francesco Carli, MD, MPhil Heather L. Gill, MCMD, MPH |
| author_sort | Miquel Coca-Martinez, MD, MSc |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T22:08:30Z |
| format | Article |
| id | doaj.art-91c66545d7b64553b50dab0b36b27592 |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-12-19T22:08:30Z |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-91c66545d7b64553b50dab0b36b275922022-12-21T20:03:58ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952021-09-0133100139Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case SeriesMiquel Coca-Martinez, MD, MSc0Francesco Carli, MD, MPhil1Heather L. Gill, MCMD, MPH2Division of Vascular Surgery, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, CanadaDepartment of Anesthesia, McGill University Health Centre, Montreal, Quebec, CanadaDivision of Vascular Surgery, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada; Corresponding author Heather L. Gill, MCMD, MPH, Division of Vascular Surgery, McGill University Health Centre, Royal Victoria Hospital, 1001 Decarie Boulevard, Montreal, Quebec, Canada H4A 3J1.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.http://www.sciencedirect.com/science/article/pii/S2590109521000495Intermittent claudicationPeripheral arterial diseasePreoperative exerciseQuality of lifeRehabilitation |
| spellingShingle | Miquel Coca-Martinez, MD, MSc Francesco Carli, MD, MPhil Heather L. Gill, MCMD, MPH Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series Archives of Rehabilitation Research and Clinical Translation Intermittent claudication Peripheral arterial disease Preoperative exercise Quality of life Rehabilitation |
| title | Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series |
| title_full | Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series |
| title_fullStr | Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series |
| title_full_unstemmed | Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series |
| title_short | Multimodal Prehabilitation to Improve Quality of Life and Functional Capacity in Peripheral Arterial Disease: A Case Series |
| title_sort | multimodal prehabilitation to improve quality of life and functional capacity in peripheral arterial disease a case series |
| topic | Intermittent claudication Peripheral arterial disease Preoperative exercise Quality of life Rehabilitation |
| url | http://www.sciencedirect.com/science/article/pii/S2590109521000495 |
| work_keys_str_mv | AT miquelcocamartinezmdmsc multimodalprehabilitationtoimprovequalityoflifeandfunctionalcapacityinperipheralarterialdiseaseacaseseries AT francescocarlimdmphil multimodalprehabilitationtoimprovequalityoflifeandfunctionalcapacityinperipheralarterialdiseaseacaseseries AT heatherlgillmcmdmph multimodalprehabilitationtoimprovequalityoflifeandfunctionalcapacityinperipheralarterialdiseaseacaseseries |