Rehabilitation for individuals with chronic limb-threatening ischemia post revascularisation: a co-created feasibility trial (HOPE)
Specialty: Cardiovascular, Primary sub-specialty: Cardiovascular; Health Category: Cardiovascular, Musculoskeletal; Disease/Condition: Diseases of arteries, arterioles and capillaries
The intervention: Participants will take part in a 12-week rehabilitation programme (as advised by NICE guidelines for PAD patients). Participants will be expected to come to either study site (MFT Manchester or HeartBeat Preston) once per week for the duration of the study. During the study visits, participants will take part in an exercise and education session. The exercise portion of the session will last approximately 1 hour and the education portion of the session will run for up to 20 minutes. During the exercise sessions, participants will take part in aerobic and resistance training exercises. The intensity of the exercise programme was informed by national guidelines obtained from the Association of Physiotherapists in Cardiovascular Rehabilitation (ACPICR). Therefore, participants will perform aerobic exercise at an intensity of 40-70% HRR, 11-14 RPE for 20-60 minutes. Resistance training will be performed at 1-3 sets, 8-10 repetitions, 11-13 RPE, incorporating all major muscle groups. Following the supervised exercise, the CLTI education session will take place (a total of six education sessions will be provided and will be delivered on a bi-weekly basis). This session will involve a presentation delivered by a member of the research team. A digital recording will be available online after the session. Written leaflets will also be disseminated online and in the session to summarise the presentation content. The education topics to be covered in these sessions will include: Introduction to physical activity and CLTI The condition and what causes it Medical conditions and risk factors related to CLTI Outcomes and what happens if nothing is done Types of surgery and what it achieves Medication and pain management Participants will also undertake a large proportion of their rehabilitation programme at home. Elements of the programme which will be home-based include walking, balance, and breathing/relaxation exercises. Strength (resistance training) and
Rehabilitation programme: 1. > = 18 years of age 2. Diagnosed with CLTI 3. Undergone open, endovascular, infra-inguinal, and/or hybrid surgery > = 4 weeks ago but within the last 3 months 4. Physically able to take part in the rehabilitation programme 5. Able to consent to study activities, participants’ must be compos mentis and able to understand spoken English Focus group: 1. Involvement in recruitment for the HOPE study OR delivery of the rehabilitation programme 2. Ability and availability to attend an in-person focus group
1. Additional surgery pending (including any surgical procedure, not only CLTI-related) 2. Unhealed surgical wounds on the legs or feet