Intermittent claudication; Exercise; Physical activity; Accelerometer; Energy expenditure Massage

Massage Therapy for patients with peripheral arterial diseases: is it scientifically useful?

ref: Arch Phys Med Rehabil. 2014 Jun; 95(6): 1127–1134

This study, a randomised controlled one was conducted to determine if lower extremity exercise-induced muscle injury (EMI) reduces vascular endothelial function of the upper extremity and if massage therapy (MT) improves peripheral vascular function after EMI. Thirty-six sedentary young adults were randomly assigned to one of three groups: 1) EMI + MT (n=15; mean age ± standard error (SE): 26.6±0.3), 2) EMI only (n=10; mean age ± SE: 23.6±0.4), and 3) MT only (n=11; mean age ± SE: 25.5 ± 0.4). Brachial artery flow-mediated dilation (FMD) was determined by ultrasound at each time point. Nitroglycerin-induced dilation was also assessed (NTG; 0.4 mg). Brachial FMD increased from baseline in the EMI + MT group and the MT only group (7.38±0.18 to 9.02±0.28%, p<0.05 and 7.77±0.25 to 10.20±0.22%, p < 0.05, respectively) at 90 minutes remaining elevated until 72 hrs. In the EMI only group FMD was reduced from baseline at 24 and 48 hrs (7.78±0.14 to 6.75±0.11%, p<0.05 and 6.53±0.11, p<0.05, respectively) returning to baseline after 72 hrs. Dilations to NTG were similar over time.

 

Those are very interesting results to the importance of massage therapy in this group of patients, and deserve further in depth look to understand the implication of this in the real life practice. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4037335/

massage_RCT2

 

 

Structured_Exercises

Home-Based Structured Exercises: are they really effective?

Ref: EJVES Dec 2013

This is a systematic review of the effectiveness of an almost self-directed structured exercise ‘activities’ on the IC patients.

The clear conclusion is that there is “low-level” evidence that Home based exercise programme (HEPs) can improve walking capacity and quality of life in patients with intermittent claudication, albeit probably to a lesser extent than supervised exercise training. The recommendation is that HEPs should be used to promote walking in patients with intermittent claudication when supervised training is unavailable or impractical.

http://www.ejves.com/article/S1078-5884(13)00562-5/pdf

 

AAA complex AAA; FEVAR; BEVAR complex EVARs EVAR familial AAA; laparoscopic aneurysm repair rupture risk ruptured aneurysm

Care for patients with AAA – a thorough approach.

Ref.: Clinical Practice Council of the Society for Vascular Surgery

I found this thorough guidelines from the Clinical Practice Council of the Society for Vascular Surgery pretty useful. It is focused, thorough, and very well thought about. Issues such as operating on patients with 5.0 -5.4cm aneurysms, comparing older trials to new EVAR era, using statins to prevent expansion of AAA, are very well documented in here.

Here is the link:

http://goo.gl/G9Fkps