Background: Peripheral arterial disease (PAD) is a chronic cardiovascular disease that mainly affects the lower limbs and whose key symptom is intermittent claudication. The onset of sudden pain forces the patient to interrupt the walk and then resume it once the symptom has disappeared. In the rehabilitation management of people with OH, the guidelines of the European Society for Vascular Surgery (ESVS) recommend treadmill training in order to increase walking distance. However, the appearance of pain during walking training is often a reason for abandonment of sessions, resulting in poor adherence to treatment. Objectives: The thesis aims to investigate the existence of supplementary or alternative rehabilitation interventions to the treadmill and/or supervised exercise programs, including treadmills, effective in increasing walking distance and at the same time able to promote greater therapeutic adherence. Materials and methods: a search of scientific articles was carried out among the main databases, PubMed, PEDro and CINAHL, setting search strings compliant with the set objective. Subsequently, the selection of the articles was carried out through identification, screening, eligibility and inclusion of the Studies. Results: The research performed included 14 articles from which the existence of other therapeutic interventions emerges, including physical therapies, Nordic walking, muscle strengthening and hydrokinesitherapy that report outcomes related to walking distance, but not all of them analyze therapeutic adherence. Significant results, in terms of walking and therapeutic adherence, have been obtained in relation to rehabilitation in water and the application of TENS in combination with the treadmill. Conclusions: This review shows that hydrokinesitherapy and TENS associated with the treadmill are treatments that have the potential to improve walking while promoting adherence to treatment. Thanks to their operating principles, they can create a situation of greater comfort and tolerance for the patient. The different physiotherapy treatment proposals aimed at the patient with PAD would require further investigation with shared research protocols, longer duration, more homogeneous and numerous study samples in order to make the efficacy results more comparable.
Background: L’arteriopatia obliterante periferica (AOP) è una patologia cardiovascolare cronica che colpisce prevalentemente gli arti inferiori e il cui sintomo cardine è la claudicatio intermittens. L’insorgenza di dolore improvvisa costringe il paziente a interrompere il cammino per poi riprenderlo una volta scomparso il sintomo. Nella presa in carico riabilitativa delle persone affette da AOP, le linee guida della European Society for Vascular Surgery (ESVS) raccomandano l’allenamento al treadmill allo scopo di aumentare la distanza di deambulazione. Tuttavia, la comparsa del dolore durante il training al cammino è spesso motivo di abbandono delle sedute determinando scarsa aderenza al trattamento. Obiettivi: La tesi si prefigge di indagare circa l’esistenza di interventi riabilitativi integrativi o alternativi al treadmill e/o programmi di esercizi supervisionati, comprensivi di treadmill, efficaci nell’aumentare la distanza di camminata e al contempo in grado di favorire una maggiore aderenza terapeutica. Materiali e metodi: è stata effettuata una ricerca di articoli scientifici tra le principali banche dati, PubMed, PEDro e CINAHL, impostando stringhe di ricerca conformi con l’obiettivo posto. Successivamente si è proceduto alla selezione degli articoli tramite identificazione, screening, eleggibilità ed inclusione degli Studi. Risultati: Dalla ricerca eseguita sono stati inclusi 14 articoli da cui emerge l’esistenza di altri interventi terapeutici, tra cui terapie fisiche, camminata nordica, rinforzo muscolare e idrokinesiterapia che riportano outcome riferiti alla distanza di deambulazione, ma non tutti prendono in analisi l’aderenza terapeutica. Risultati significativi, in termini di deambulazione e aderenza terapeutica, sono stati ottenuti relativamente alla riabilitazione in acqua e all’applicazione di TENS in combinazione al treadmill. Conclusioni: Da questa revisione emerge che l’idrokinesiterapia e la TENS associata al treadmill sono trattamenti potenzialmente in grado di migliorare il cammino favorendo al contempo l’aderenza al trattamento. Grazie ai loro principi di funzionamento, possono creare una situazione di maggiore comfort e tolleranza per il paziente. Le diverse proposte di trattamento fisioterapico rivolte al paziente con AOP richiederebbero ulteriori approfondimenti con protocolli di ricerca condivisi, durata maggiore, campioni di studio più omogenei e numerosi al fine di rendere più confrontabili i risultati di efficacia.
Nuove evidenze nella riabilitazione dell'Arteriopatia Obliterante Periferica: solo esercizio fisico su treadmill? Una revisione della letteratura
CARUSO, MARCO
2023/2024
Abstract
Background: Peripheral arterial disease (PAD) is a chronic cardiovascular disease that mainly affects the lower limbs and whose key symptom is intermittent claudication. The onset of sudden pain forces the patient to interrupt the walk and then resume it once the symptom has disappeared. In the rehabilitation management of people with OH, the guidelines of the European Society for Vascular Surgery (ESVS) recommend treadmill training in order to increase walking distance. However, the appearance of pain during walking training is often a reason for abandonment of sessions, resulting in poor adherence to treatment. Objectives: The thesis aims to investigate the existence of supplementary or alternative rehabilitation interventions to the treadmill and/or supervised exercise programs, including treadmills, effective in increasing walking distance and at the same time able to promote greater therapeutic adherence. Materials and methods: a search of scientific articles was carried out among the main databases, PubMed, PEDro and CINAHL, setting search strings compliant with the set objective. Subsequently, the selection of the articles was carried out through identification, screening, eligibility and inclusion of the Studies. Results: The research performed included 14 articles from which the existence of other therapeutic interventions emerges, including physical therapies, Nordic walking, muscle strengthening and hydrokinesitherapy that report outcomes related to walking distance, but not all of them analyze therapeutic adherence. Significant results, in terms of walking and therapeutic adherence, have been obtained in relation to rehabilitation in water and the application of TENS in combination with the treadmill. Conclusions: This review shows that hydrokinesitherapy and TENS associated with the treadmill are treatments that have the potential to improve walking while promoting adherence to treatment. Thanks to their operating principles, they can create a situation of greater comfort and tolerance for the patient. The different physiotherapy treatment proposals aimed at the patient with PAD would require further investigation with shared research protocols, longer duration, more homogeneous and numerous study samples in order to make the efficacy results more comparable.| File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/75766