York St John launch new exercise therapy service for patients with peripheral artery disease

Claudication is a symptom of peripheral artery disease. Those who experience intermittent claudication have pain in their legs that occurs while walking, caused by too little blood flow. At rest or when doing small amounts of activity, the body is able to deliver blood and oxygen to the tissues in the leg and foot, however during greater physical activity the demand for oxygen in the muscles is higher and the body can’t keep up due to narrowing or blockage of an artery. Peripheral artery disease affects around 13% of adults over 50 years old, with factors such as smoking, diabetes, high blood pressure and high cholesterol adding to the risk of claudication.

Exercise therapy is a cornerstone in the management of intermittent claudication. Newly diagnosed patients with intermittent claudication will be invited to attend two 1-hour sessions per week over a 12-week programme. Various patient outcomes will be measured at the beginning and end of the 12-week programme using questionnaires, walking distance tests and service user evaluation forms. The assessments will take place in a new clinical research room on the University’s Lord Mayor’s Walk campus. The service will be closely supervised by a vascular clinician and nurse, with specialist clinical oversight to the exercise programme from a cardiology physiotherapist. Following completion of the 12-week programme, patients will transition to community-based exercise alongside guidance on behavioural interventions and risk factor counselling.

The exercise sessions will take place at the Haxby Road Sports Park where groups of up to 10 patients will attend the structured sessions consisting of: 10-minute warm-up; 40 minutes of shuttle walking (6 minutes walking, 2 minutes rest, repeated 5 times); 10-minute cooldown including exercises to improve strength, balance and flexibility.

The academic lead for the service is Garry Tew, Professor of Clinical Exercise Science at York St John University and Director of the Institute for Health and Care Improvement (IHCI). Describing the importance of the claudication exercise service he said:

“Supervised exercise therapy is a safe, effective and low-cost intervention for improving health outcomes in people with intermittent claudication. Clinical guidelines advocate exercise as a first-line intervention. Exercise therapy is an area of growing activity at the University and the new service addresses a vital gap in local service provision.”

The service is also providing new opportunities for research. Lisa Sharpe, a vascular specialist nurse from York Hospital, is doing a part-time Masters by Research with the Institute for Health and Care Improvement. Her project will focus on the feasibility of establishing a new claudication exercise service in York.

The clinical lead for the service is Mr Andrew Thompson, Consultant Vascular Surgeon at York and Scarborough Trust. He said:

“We hope to offer this new service to patients referred by their GP with severe symptoms. This will provide people suffering with peripheral artery disease an opportunity to improve their quality of life, as well as providing long standing general health benefits. We are very excited to be offering this service in collaboration with York St John University.”

In addition, Professor Tew and Mr Thompson have been awarded a research grant to establish a peripheral artery disease research database for York and Scarborough Teaching Hospitals NHS Foundation Trust. Supported by competitive charitable funding from the Elsie May Sykes award, the initiative aims to enhance patient care and facilitate research.