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Preferred exercise modalities in patients with intermittent claudication

Harwood, Amy; Hitchman, Louise Helen; Ingle, Lee; Doherty, Patrick; Chetter, Ian Clifford


Amy Harwood

Louise Helen Hitchman

Patrick Doherty

Ian Clifford Chetter


Conventional supervised exercise programs (SEPs) for claudicants are traditionally based on time-constrained, group-based structured programs usually at a hospital site. Uptake of an SEP is poor, despite the high-level evidence demonstrating its clinical effectiveness; therefore, alternative forms of exercise programs are needed which are more acceptable to patients. This study aimed to explore a range of exercise modalities to determine patient preferences for exercise delivery on a national level. This was a questionnaire survey to identify and incorporate patient preferences when designing a multicenter nationwide health-service evaluation of patient preference to exercise in the United Kingdom's National Health Service (the PREFER study). Patients with documented stable intermittent claudication who were suitable for an SEP were given a questionnaire to fill out at their clinic visit. Data were recorded using the Bristol Online Survey tool ( and analyzed descriptively. Thirty complete questionnaires were analyzed. Participants were generally unilateral claudicants (80%) with symptoms for over 1 year (64%). Only 6 of the 30 patients had engaged in a lifelong routine of exercise. Eighty-seven percent of patients indicated that they had not taken part in an exercise program, but 73% of those indicated that they would be willing to participate to improve their walking. Most patients expressed a preference for a home exercise program (50%) followed by a hospital SEP. The majority of patients (43%) were happy to exercise 3 days per week using a walking-based program (53%). There was however no consensus on the duration or intensity of the exercise program. The SEP is the recommended first-line treatment for intermittent claudication patients; however, the vast majority of patients fail to engage with or complete an exercise program. This study demonstrates that exercise therapy should be individualized and take a patient-centered approach. Commissioning groups should incentivize hospitals and clinicians to engage with their patient populations to understand their needs and deliver an appropriate service.


Harwood, A., Hitchman, L. H., Ingle, L., Doherty, P., & Chetter, I. C. (2018). Preferred exercise modalities in patients with intermittent claudication. Journal of Vascular Nursing, 36(2), 81-84.

Journal Article Type Article
Acceptance Date Dec 22, 2017
Online Publication Date Feb 2, 2018
Publication Date 2018-06
Deposit Date Jan 30, 2018
Publicly Available Date Feb 3, 2019
Print ISSN 1062-0303
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 36
Issue 2
Pages 81-84
Keywords Medical–Surgical
Public URL
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