Key result
Post-revascularisation exercise rehab in PAD improves walking capacity, but limb-related events and safety remain underreported.
Why the study?
Exercise therapy is recommended for peripheral arterial disease, but rehabilitation programmes following lower-limb revascularisation remain poorly defined.
Does exercise-based rehabilitation improve walking capacity and clinical outcomes in adult patients with peripheral arterial disease following lower-limb revascularisation?
Systematic Review
Does exercise-based rehabilitation improve walking capacity and clinical outcomes in adult patients with peripheral arterial disease following lower-limb revascularisation?
Exercise-based rehabilitation after lower-limb revascularisation demonstrates consistent functional benefits in walking capacity, but standardisation is lacking and critical vascular and safety outcomes are severely underreported.
Lack of standardisation and underreporting of safety/limb outcomes warrant caution in post-revascularisation PAD exercise programmes; leaves open optimal protocols for prospective trials.
Objective: Exercise therapy is recommended for patients with peripheral arterial disease (PAD) to improve walking capacity and functional outcomes. However, rehabilitation programmes after lower-limb revascularisation remain poorly defined. We aimed to map the existing literature on exercise-based rehabilitation following lower-limb revascularisation in patients with PAD and summarise key intervention features and reported outcomes. Data Sources: PubMed/MEDLINE, Embase, the Physiotherapy Evidence Database (PEDro), and the Cochrane Central Register of Controlled Trials were systematically searched from inception to identify relevant studies. Review Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Studies involving adult patients with PAD or chronic limb-threatening ischaemia who underwent lower-limb revascularisation and participated in postoperative exercise or rehabilitation programmes were included. Two reviewers independently screened studies and extracted data on study characteristics, intervention components, and outcomes. Findings were synthesised descriptively and presented in tables and narrative summaries. Results: Fourteen studies were included. Rehabilitation programmes showed substantial heterogeneity in exercise modality, timing of initiation, intensity, supervision, and duration. Walking-based exercise was the most commonly reported modality. Sessions typically lasted 20–60 min. Exercise frequency ranged from daily inpatient mobilisation or 6 days/week during early rehabilitation to two to five sessions/week in outpatient or home-based programmes, and programme length ranged from inpatient-only rehabilitation to 12 months. The most frequently reported outcomes were measures of walking capacity, including treadmill walking distance and the 6 min walk test. In contrast, limb-related outcomes (e.g., wound healing, limb salvage, and reintervention) and safety outcomes were less frequently reported. Conclusions: Exercise-based rehabilitation after lower-limb revascularisation in patients with PAD demonstrates considerable variability in programme characteristics and outcome measures. Although most studies focus on walking performance, key outcomes—particularly limb-related events and safety—remain underreported. Future research should establish standardised postoperative rehabilitation protocols and evaluate a broader range of clinically relevant outcomes, especially in patients with chronic limb-threatening ischaemia.
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Watanabe et al. (2026) conducted a systematic review in Peripheral Arterial Disease (PAD) and Chronic Limb-Threatening Ischaemia (CLTI). Exercise-based rehabilitation was evaluated. Exercise-based rehabilitation after lower-limb revascularisation in patients with PAD demonstrates considerable variability in programme characteristics, with most studies focusing on walking performance while limb-related events and safety remain underreported.
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