Exercise Therapy: A Walk to Wellness

Top Workouts to Manage Peripheral Artery Disease

Exercises for PAD

Imagine taking a leisurely stroll through your neighborhood, enjoying the sights and sounds of the world around you. Suddenly, excruciating pain shoots through your left calf, forcing you to stop and catch your breath on the side of the road. This nightmare became a reality for Jagdish Bhatnagar, an 83-year-old retiree from Pittsburgh. Diagnosed with peripheral artery disease (PAD), a condition caused by blocked blood vessels in his leg, Bhatnagar’s cramps had become unbearable. But instead of resorting to surgery or medication, he found a surprising solution that would help him reclaim his mobility and vitality: supervised exercise therapy (SET).

Since Medicare’s decision to cover SET in 2017, this innovative treatment has been gradually gaining popularity across the United States. It turns out that SET can do wonders for people like Bhatnagar, enabling them to walk longer and more comfortably. By participating in a SET program, which consists of treadmill walking and other exercises, individuals with PAD can improve their circulation and alleviate the debilitating pain associated with the disease. Bhatnagar, an 83-year-old retired medical physicist, is a shining example of the transformative power of exercise. He states, “I feel like I’m getting rejuvenated with this exercise. Before, I felt like a sick person. But now, I feel like I’m becoming healthy.”

Let’s dig deeper into how exercise therapy works its magic. Treadmill walking, the cornerstone of SET programs, is the gold standard for combating PAD’s primary symptom: claudication. Claudication refers to the pain and cramping experienced in the calf, thigh, or buttocks while walking, resulting from inadequate oxygen supply to the leg muscles. Mark Jordan, a senior clinical exercise physiologist, explains that walking improves muscle oxygenation and promotes the development of new blood vessels, ultimately enhancing circulation to the leg. In other words, walking is like a superhero, swooping in to save the day and deliver that much-needed oxygen boost.

A typical SET program consists of up to 36 sessions spread over 12 weeks, with each session lasting between 30 and 60 minutes. It all starts with a walking test to gauge your pain threshold. Based on these results, your SET team will design a personalized exercise plan, alternating between periods of walking and resting. As you make progress, your therapist will gradually increase the treadmill’s speed, incline, and duration. Believe it or not, there’s even a pain scale involved. Jordan explains, “We use a 1 to 5 pain scale for patients to rate their pain while walking. Once they reach level 4, we have them take a break. After their pain subsides, they get back on the treadmill and repeat the process several times until they’ve been walking for a total of 60 minutes.”

But wait, there’s more! SET programs often incorporate other forms of exercise to keep things interesting. Picture yourself pedaling away on an ergometer, a bicycle-like contraption operated with your arms. Alongside this, stationary bikes, rowing machines, arm and leg weights, and educational sessions on healthy eating may all be part of the program. Vascular surgeon, Oliver Aalami, MD, emphasizes that any movement can be beneficial, but if you’re specifically aiming to alleviate walking discomfort, well, walking reigns supreme. It’s all about those leg muscles, people!

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Now, you might be thinking, “Why would I subject myself to pain willingly?” Good question! The answer lies in the remarkable results achieved through SET programs. Research shows that SET can be just as effective as invasive PAD treatments, like stent placement surgery, and can also reduce the risk of heart attacks and strokes. As if that wasn’t impressive enough, engaging in supervised exercise offers additional advantages over exercising alone. Not only does it keep you accountable and motivated, but you also benefit from the expert guidance and monitoring provided by medical professionals. They’ll keep an eye on your heart rate and blood pressure, making sure you’re on the right track to a healthier you.

It’s important to note that while pain is typically an alarm bell signaling us to stop, it plays a unique role in the context of exercise therapy. In fact, experiencing calf pain is expected and even necessary to effectively treat PAD through exercise. Aalami reassures patients, saying, “It’s okay to experience the calf pain.” He understands that this discomfort can be discouraging at times but emphasizes the numerous benefits awaiting those who embrace it. Jordan echoes this sentiment by stressing that pain management is an important aspect of SET programs, and therapists guide patients through the process, pushing them gently past their comfort zones to reach the optimal level of pain required for positive outcomes.

Now, before you rush off to find the nearest SET program, there’s a small caveat to consider. These programs may not be readily available in all areas, so it’s crucial to check with your doctor about the availability of SET treatments in your local community. Rest assured, most private insurance plans cover SET, and Medicare provides coverage as well. However, it’s always best to clarify the specifics with your insurance provider.

But what if, despite your best efforts, you can’t find a nearby SET program? Fear not! Help is on the way in the form of a cutting-edge mobile phone app developed by the Society for Vascular Surgery. This innovative solution will allow individuals like Doug Giller, a 63-year-old retiree from Lansing, MI, to participate in SET virtually. The app not only provides exercise guidance and reminders but also offers telephone consultations with medical professionals who will guide and support users through their journey to improved health.

Giller, a self-described “Type A personality,” was diagnosed with PAD in 2019 after experiencing excruciating pain in his right calf during a walk. Determined to combat the disease, he implemented a daily hour-long walking routine around his large house. Thanks to his resilience and the assistance of the SET app, Giller has seen remarkable progress. He proudly shares, “I got new carpet last year, and I can almost see a path through it. It’s like a racetrack now.”

The impact of SET can be truly life-changing. Bhatnagar, for instance, no longer experiences leg pain while walking. He joyfully navigates the hills and valleys of his neighborhood, feeling like a new person. Giller, while still experiencing some pain, sees it as a constant reminder to keep pushing forward. He exclaims, “It’s nothing compared to the pain I felt when I first started. I’m effectively paving new paths for my lifeblood to flow to my leg.” Giller’s doctor even concurs that his right leg’s blockage has significantly improved, to the point where stent surgery is no longer recommended.

So, if you’ve been battling with PAD and thought your mobility was forever compromised, think again! Exercise therapy, whether through a supervised program or a state-of-the-art app, holds the key to restored freedom and renewed vitality. Embrace the pain, knowing that it’s your pathway to a healthier and happier life.

Now it’s your turn! Have you tried exercise therapy? Share your experience and thoughts in the comments below. Let’s inspire each other on this journey to improved health!