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      Vascular rehabilitation interventions in people with peripheral arterial disease: an integrative review

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          Abstract

          Background

          Peripheral artery disease, which occurs due to lower limb artery disorders, is associated with high cardiovascular mortality rates. Studies show that supervised exercise is an effective option for controlling symptoms.

          Objective

          This study identified exercise types and complementary therapies used for vascular rehabilitation in people with peripheral artery disease and discusses the best recommendations in the literature.

          Methods

          This integrative literature review is based on studies published in the last 5 years. The search was performed in the following databases: PubMed, SciELO, LILACS (BVS), and Cochrane. In addition to supervised exercise, the interventions in the clinical trials included other approaches that contributed to patient rehabilitation. Duplicate articles, articles whose full text was unavailable, and those whose title or abstract indicated they were unrelated to the topic were excluded.

          Results

          Nine articles were included in the analysis. The results indicate that supervised exercise is the gold standard treatment method. However, therapies such as blood flow restriction, heat therapy, hydrotherapy, and resistance training can help improve treatment adherence, and their complementary effects benefit cardiovascular and physical function.

          Conclusions

          In patients with peripheral artery disease, exercise-based rehabilitation is fundamental. However, resistance training with blood flow restriction can optimize muscle strength, while heat therapy and hydrotherapy can act as adjuvants to exercise.

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          Most cited references21

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          Integrative review: what is it? How to do it?

          ABSTRACT Introduction: The integrative review is the methodology that provides synthesis of knowledge and applicability of results of significant studies to practice. Objective: To present the phases of an integrative review and the relevant aspects to be taken into account when using this methodological resource. Methods: This study was based on bibliographic search and on the experience of the authors when performing an integrative review. Results: Presentation of the six stages of the integrative review process: preparing the guiding question, searching or sampling the literature, data collection, critical analysis of the studies included, discussion of results and presentation of the integrative review. Conclusions: Considering the need to assure care based on scientific evidence, the integrative review has been identified as a unique tool in healthcare for it synthesizes investigations available on the given topic and guides practice based on scientific knowledge.
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            Lower Extremity Peripheral Artery Disease: Contemporary Epidemiology, Management Gaps, and Future Directions: A Scientific Statement From the American Heart Association

            Lower extremity peripheral artery disease (PAD) affects >230 million adults worldwide and is associated with increased risk of various adverse clinical outcomes (other cardiovascular diseases such as coronary heart disease and stroke and leg outcomes such as amputation). Despite its prevalence and clinical importance, PAD has been historically underappreciated by health care professionals and patients. This underappreciation seems multifactorial (eg, limited availability of the first-line diagnostic test, the ankle-brachial index, in clinics; incorrect perceptions that a leg vascular disease is not fatal and that the diagnosis of PAD would not necessarily change clinical practice). In the past several years, a body of evidence has indicated that these perceptions are incorrect. Several studies have consistently demonstrated that many patients with PAD are not receiving evidence-based therapies. Thus, this scientific statement provides an update for health care professionals regarding contemporary epidemiology (eg, prevalence, temporal trends, risk factors, and complications) of PAD, the present status of diagnosis (physiological tests and imaging modalities), and the major gaps in the management of PAD (eg, medications, exercise therapy, and revascularization). The statement also lists key gaps in research, clinical practice, and implementation related to PAD. Orchestrated efforts among different parties (eg, health care providers, researchers, expert organizations, and health care organizations) will be needed to increase the awareness and understanding of PAD and improve the diagnostic approaches, management, and prognosis of PAD.
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              Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease: The LITE Randomized Clinical Trial

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                Author and article information

                Contributors
                Role: conception and designRole: analysis and interpretationRole: data collectionRole: writing the articleRole: critical review of the articleRole: statistical analysisRole: overall responsibilityRole: have read and approved the final manuscript submitted to J Vasc Bras
                Role: critical review of the articleRole: statistical analysisRole: have read and approved the final manuscript submitted to J Vasc Bras
                Role: critical review of the articleRole: statistical analysisRole: have read and approved the final manuscript submitted to J Vasc Bras
                Role: final approval of the articleRole: statistical analysisRole: overall responsibilityRole: have read and approved the final manuscript submitted to J Vasc Bras
                Role: final approval of the articleRole: statistical analysisRole: overall responsibilityRole: have read and approved the final manuscript submitted to J Vasc Bras
                Role: conception and designRole: analysis and interpretationRole: writing the articleRole: critical review of the articleRole: final approval of the articleRole: statistical analysisRole: overall responsibilityRole: have read and approved the final manuscript submitted to J Vasc Bras
                Journal
                J Vasc Bras
                J Vasc Bras
                jvb
                Jornal Vascular Brasileiro
                Sociedade Brasileira de Angiologia e de Cirurgia Vascular (SBACV)
                1677-5449
                1677-7301
                14 March 2025
                2025
                : 24
                : e20240088
                Affiliations
                [1 ] originalUniversidade Federal da Paraíba – UFPB, João Pessoa, PB, Brasil.
                [1 ] originalUniversidade Federal da Paraíba – UFPB, João Pessoa, PB, Brasil.
                Author notes

                Conflicts of interest: The authors have no conflicts of interest to declare.

                Correspondence Kauane Flechas Arruda Perdigão Universidade Federal da Paraíba – UFPB Campus I - Jardim Cidade Universitária CEP: 58051-900 - João Pessoa (PB), Brasil Tel: +55 (83) 99960-1818 E-mail: kauane.flechas@ 123456academico.ufpb.br

                Conflito de interesse: Os autores declararam não haver conflitos de interesse que precisam ser informados.

                Correspondência Kauane Flechas Arruda Perdigão Universidade Federal da Paraíba – UFPB Campus I - Jardim Cidade Universitária CEP 58051-900 - João Pessoa (PB), Brasil Tel: (83) 99960-1818 E-mail: kauane.flechas@ 123456academico.ufpb.br
                Author information
                http://orcid.org/0009-0009-1302-1015
                http://orcid.org/0000-0003-2063-0731
                http://orcid.org/0009-0004-7112-1632
                http://orcid.org/0000-0002-0176-6222
                http://orcid.org/0000-0001-9207-2180
                http://orcid.org/0000-0001-9858-2990
                Article
                jvbAO20240088_PT 00307
                10.1590/1677-5449.202400882
                11922327
                40109307
                606beef1-c161-4139-b639-2e479fbfd1d9
                Copyright© 2025 The authors

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 July 2024
                : 06 December 2024
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 21
                Categories
                Original Articles

                exercise therapy,peripheral arterial disease,rehabilitation

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