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Treatment efficacy of intermittent claudication by invasive therapy, supervised physical exercise training compared to no treatment in unselected randomised patients II: one-year results of health-related quality of life.

Artikel i vetenskaplig tidskrift
Författare Charles Taft
Jan Karlsson
Johan Gelin
Lennart Jivegård
R Sandström
B Arfvidsson
A G Dahllöf
Kent Lundholm
Marianne Sullivan
Publicerad i European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
Volym 22
Nummer/häfte 2
Sidor 114-23
ISSN 1078-5884
Publiceringsår 2001
Publicerad vid Institutionen för de kirurgiska disciplinerna
Institutionen för invärtesmedicin
Institutionen för de kirurgiska disciplinerna, Avdelningen för kirurgi
Sidor 114-23
Språk en
Länkar dx.doi.org/10.1053/ejvs.2001.1406
Ämnesord Activities of Daily Living, classification, Adult, Aged, Aged, 80 and over, Exercise, Exercise Test, Female, Follow-Up Studies, Humans, Intermittent Claudication, surgery, Male, Middle Aged, Prospective Studies, Quality of Life, Sickness Impact Profile, Treatment Outcome
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

OBJECTIVE: to compare the effectiveness of invasive therapy, supervised physical training and no treatment in terms of health-related quality of life (HRQL) in patients with intermittent claudication (IC). DESIGN: a prospective, randomised, controlled study. MATERIALS: a total of 253 unselected patients with stable IC were sequentially randomised into 3 balanced treatment groups. At 1 year follow-up data from a battery of generic and disease specific HRQL questionnaires, and global indices of quality of life and physical condition were available in 171 patients. RESULTS: compared with a non-diseased reference group, claudicants were substantially limited in daily physical functioning, but little affected regarding emotional, cognitive and social functioning, or well-being. Invasive therapy yielded significantly greater improvements in some aspects of physical functioning and walk-related symptoms than training. Training was not superior to invasive therapy on any HRQL dimension and superior to no treatment on only one dimension. Treatment effects, however, were generally small-to-moderate and levels of physical dysfunction in all groups remained higher than reference values. CONCLUSIONS: invasive therapy is more effective than supervised training in alleviating illness-specific symptoms and improving certain aspects of physical functioning - the primary HRQL domains impacted on by IC and the principal goals of its treatment. However, since treatment effect sizes were at most moderate and given that untreated claudicants reported at most small deterioration in HRQL, the level of evidence supporting invasive therapy is modest.

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