Exercise Rehabilitation in Veterans With PAD
Exercise Rehabilitation in Veterans With PAD
Peripheral artery disease (PAD) results in blockages of arteries (blood vessels) and
 decreased blood flow to the legs. This may cause difficulty or pain with walking or other
 activities that use leg muscles. Exercise may help improve blood flow in the legs and improve
 the ability to walk. This research project will be conducted patients with PAD that require
 revascularization. The goal is to examine the effects of 3 months of exercise rehabilitation
 or neuromuscular stimulation on leg blood flow, physical function, quality of life and
 general health.
Peripheral artery disease (PAD) and its associated declines in physical function impair
 quality of life (QOL) in nearly 20% of older Veterans and result in substantial VA health
 care costs. Revascularization addresses the anatomical pathology, but does not restore
 mobility function and QOL. Optimal therapy may require post-revascularization rehabilitation
 to address lingering defects in skeletal muscle that limit function; however, the current
 standard of care after revascularization does not include rehabilitation. Exercise training
 and neuromuscular electrical stimulation (NMES) may enhance function by increasing muscle
 perfusion to improve outcomes in older Veterans with PAD after revascularization.

 The investigators will enroll Veterans (50-80 years of age) with PAD who are planned for
 percutaneous revascularization. Participants will complete research testing consisting of: a)
 Assessment of mobility function and QOL; and b) Treadmill tests to assess ambulatory
 capacity, and calf muscle perfusion. Participants will undergo screening prior to
 revascularization and will have baseline testing 2-3 weeks after revascularization. After
 post-revascularization testing, patients will be randomized to Exercise-only or NMES-only.
 After completion of the 3-month intervention, participants will repeat all tests to determine
 the effects of the interventions.
Inclusion Criteria:

 -  Diagnosis of peripheral arterial disease; or ankle-brachial index <0.9.

 -  Planned to undergo endovascular revascularization within 6 months.

 Exclusion Criteria:

 -  Cancer under active treatment

 -  Planned for lower extremity bypass surgery

 -  Body mass index > 45 kg/m2

 -  Critical limb ischemia or lower extremity gangrene