With
Peripheral Vascular Disease
Effects of Physical Therapy on Patients with Peripheral Vascular Disease
The term Peripheral Vascular Disease stands for systemic manifestations of atherosclerosis leading to narrowing of the arteries lying distal to the arch of aorta. The commonest manifestation of Peripheral Vascular Disease is the intermittent claudication of the affected organ. At times, this disease condition may lead to acute or critical ischaemia of the affected limb. Intermittent claudication can be explained as the pain of the limbs on exercise or exertion, this symptom is commonly seen in the lower limbs. The prevalence of such intermittent claudication is 2 per cent above the age of 65 years. On examination, the findings will correspond to abnormality in the pedal pulsations, bruit in the femoral artery, delayed filling time of the veins, skin cold to touch, abnormality in the color of the skin. Most of the patients of peripheral vascular disease present with very subtle symptoms and lack any definite evidence to reach to the diagnosis. The standard test that can be conducted within the clinical set up for confirmation of the diagnosis is the ankle brachial index. At times, more detailed non invasive tests may be required, especially when the findings of the ankle brachial index are not corroborative enough to conclude the diagnosis. These tests are Magnetic resonance arteriography, hemodynamic localization and duplex scanning. Often contrast arteriograhy is done prior to any intervention in order to confirm the localization. Treatment may consist of lifestyle modifications, medical therapies and surgical interventions. The lifestyle modifications will consist of cessation of smoking, physical exercises, and dietary changes. Medical therapy aims at decreasing the tendency for platelet aggregation. The patients having pre existing diseases like hypertension, diabetes and hyperlipidemia need extra medical attention. Surgical interventions include stent implantation, angioplasty, bypass grafting, and arterectomy (Sontheimer, 2006).
Peripheral vascular diseases affect the general life of the patient to a great extent. It affects their ability to walk for long or carry out heavy physical tasks. Initially, the pain develops only after a prolonged walking. With gradual progression of the disease, the pain develops even after a shorter duration of walking. As the condition becomes more severe, the pain develops even at rest (McDermott et al., 1999).
Physical therapies significantly improve the condition of the patients suffering from peripheral vascular disease. Different types of intervention plans include supervised physical training and therapeutic education. According to an article published in the PubMed, some of the proved benefits of physical therapy are improvement or increase in the pain free walking distance, improved quality of life, reduction in the risk factors associated with cardiovascular diseases. The article recommends three weekly sessions of physical therapy over a time period of three months (Casillas et al., 2011).
Another article in PubMed recommends supervised physical training or exercise programs as the first line of treatment for claudication. However, studies have also shown that even in patients of peripheral vascular disease without claudication the implementation of physical therapy provides great results (Hamburg & Balady, 2011).
It is highly recommended that the involved physical therapists should have adequate knowledge about the restrictions and limitations of the condition and the extent till which a person can tolerate exercise. The physical therapist should have knowledge about the condition, the resultant degree of immobility, progression of the disease and the prognosis. He should be well aware about what should be expected and what not. He should know the physical constraints that a patient suffering from this condition experiences.
Talking about the articles included in the paper, it can be said that they are authentic and are of very high value. They have been procured from the renowned PubMed database. All the articles belong to renowned authors. The claims of those authors are further supported by other authors through included citations in the articles. These are works of high precision and quality. One article described about the condition in general including its symptomatic manifestations, age prevalence, physical findings and treatment options. The other two articles bring about the importance of physical therapy in the treatment of the disease condition.
The article by Hamburg and Balady is a meta- analytical review of various studies found over a period of time from other databases. It is basically a literature review of the researches done in the past about the applicability of physical therapy in treating patients with Peripheral vascular disease. the other article by Mary McGrae McDermott, Shruti Mehta, Kiang Liu, Jack M Guralnik, Gary J Martin, Michael H Criqui, and Philip Greenland discusses about the severity of the different symptoms experienced by the patients of the disease. This was a quantitative study done with the aim of analyzing the different sets of symptoms experienced by the selected group of patients. Both the articles contain valid results which are in line with the discussion and present the facts in the best possible way. They are reliable and the findings are corroborative with the findings of other articles and research workers. The references are listed properly at the end of each article in proper format with appropriate in- text citation.
The articles included in this paper deal with an important topic which is of much importance for the medical fraternity. The condition is usually seen among the aged people, above the age group of 65. The most striking symptom of the condition is the presence of intermittent claudication. The patients initially develop pain on prolonged walking, with progression in the disease condition the pain may appear even at rest.
References
Casillas, J., Troisgros, O., Hannequin, A., Gremeaux, V., Ader, P., Rapin, A., & Laurent, Y. (2011). Rehabilitation in patients with peripheral arterial disease. Annals Of Physical And Rehabilitation Medicine, 54(7), 443-461. http://dx.doi.org/10.1016/j.rehab.2011.07.001
Hamburg, N., & Balady, G. (2011). Exercise Rehabilitation in Peripheral Artery Disease: Functional Impact and Mechanisms of Benefits. Circulation, 123(1), 87-97. http://dx.doi.org/10.1161/circulationaha.109.881888
McDermott, M., Mehta, S., Liu, K., Guralnik, J., Martin, G., Criqui, M., & Greenland, P. (1999). Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease.J Gen Intern Med, 14(3), 173-181. http://dx.doi.org/10.1046/j.1525-1497.1999.00309.x
Sontheimer, D. (2006). Peripheral vascular disease: diagnosis and treatment. Pubmed, 73(11), 1971-1976. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16770929
