Lower extremity peripheral artery disease: implications for physiotherapy

Abstract

Peripheral artery disease (PAD) is more prevalent among the elderly and is a predictor of cardiovascular mortality causing high morbidity. It is commonly associated with other illnesses such as diabetes mellitus, cerebrovascular and coronary heart disease. Even when asymptomatic, PAD patients are often treated by a physiotherapist, either specifically for lower extremity PAD or during rehabilitation for other clinical conditions, where PAD is a comorbidity. As such, physiotherapists need to better understand the clinical presentation of the disease, treatment options and precautions to be adopted when treating these patients. The objective of this brief review is to synthesize data regarding PAD epidemiology, consensus on lower extremity PAD treatment, precautions for assessing and handling PAD patients and present information on new PAD treatment options under evaluation. The supervised exercise/rehabilitation program for PAD should be the mainstay of patient treatment, owing to its clinical effectiveness demonstrated in several studies; however, there is paucity of data about long-term effects of exercise programs for PAD patients on mortality or incidence of revascularization and amputations. New PAD treatments, such as cell therapy, appear promising.