Supervised exercise therapy for patients with peripheral artery disease: Clinical update and pathways forward

Peripheral artery disease (PAD) is an atherosclerotic vascular disease resulting in pervasive morbidity and mortality, particularly among older adults. One first-line therapy to improve symptoms, function, and clinical outcomes in PAD is supervised exercise therapy (SET), which is based primarily on a structured, start-and-stop walking protocol and is often implemented in cardiac rehabilitation programs. SET is supported by a Class IA guideline for patients with symptomatic PAD; however, despite the effectiveness of SET and the 2017 CMS decision to cover SET for PAD, challenges of awareness, access, and implementation of SET persist. Recent efforts to address these challenges include digital health and hybrid approaches to SET that may minimize barriers to care by delivering SET in more innovative, flexible formats. Further study is needed to understand barriers, improve awareness, and implement SET in more equitable and accessible ways. (C) 2022 Elsevier Inc. All rights reserved.

Automated summary

Peripheral artery disease (PAD) is a common form of atherosclerosis, particularly in older adults. Supervised exercise therapy (SET) is an effective treatment for improving symptoms and clinical outcomes, but challenges remain in terms of awareness, access, and implementation. Digital health and hybrid approaches may offer solutions to these challenges.