The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Supervised vs home exercise to treat intermittent claudication

    Intermittent claudication is a diagnosis for muscle pain (ache, cramp, numbness, or sense of fatigue) typically in the calf muscle, which occurs during exercise and is relieved by a short period of rest.

    Researchers at Oklahoma University Health Sciences Center, in Oklahoma City, compared home-based exercise to a supervised exercise program.

    First, the details.

    • 119 patients were randomly assigned to a treatment group.
      • Home-based exercise: intermittent walking to nearly maximal claudication pain for 12 weeks
      • Supervised exercise: as above but supervised
      • Usual-care
    • Patients wore a step activity monitor during each exercise session.
    • Claudication onset time and peak walking time obtained from a treadmill exercise test were recorded as the primary outcomes.
    • Daily ambulatory cadences (measure or beat of movement) measured during a 7-day period were also recorded.

    And, the results.

    • Adherence to home-based and supervised exercise was similar and exceeded 80%.
    • Both exercise programs significantly delayed claudication onset time and increased peak walking time.
    • Only home-based exercise increased daily average cadence significantly.
    • There were no changes in the usual care group.

    The bottom line?

    The authors concluded, “A home-based exercise program… has high adherence and is efficacious in improving claudication measures similar to a standard supervised exercise program. Furthermore, home-based exercise appears more efficacious in increasing daily ambulatory activity in the community setting than supervised exercise.”

    The authors tell us this is the first well-designed study to compare supervised vs home exercise for intermittent claudication. The findings suggest reconsidering the role of supervised exercise in these patients.

    4/21/11 22:04 JR

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