Literature review of exercise interventions for peripheral arterial disease.

Peripheral arterial disease (PAD) can lead to a narrowing of the blood vessels that supply the legs with oxygen. This can cause cramp-like muscle pain in the calf and thigh brought on by walking and relieved by rest. This is called intermittent claudication (IC). Exercise is seen as a positive form of treatment for these symptoms, and supervised exercise programmes (SEPs) can help people to walk further without feeling pain. However, many people decline to take part, or do not continue to exercise after supervision has finished, losing the benefit and leading to a return of symptoms.

There may be many reasons why people do not want to take part in SEPs, or why they do not continue to be active afterwards. For example, some people may not feel comfortable exercising in a group. In addition, hospital based classes can cause problems with travel and parking for patients. Providing a more flexible approach, based in a local community or primary care setting may enable more people with PAD to take part in and benefit from exercise.

The purpose of this research is to explore the reasons why people with PAD and similar diseases known to benefit from exercise:

1) decline to take part in a SEP;

2) often fail to complete the programme;

3) do not remain physically active after the SEP has finished.

We will review the scientific evidence on the effectiveness of primary care based exercise/activity programmes for people with PAD and related conditions (e.g. heart disease). We will look at why people fail to engage with such programmes, including the reasons for not taking up the offer, failing to complete, and failing to continue being physically active after supervision has finished.

We will then begin to develop ways to improve uptake and engagement with these programmes.