Primärtherapie der Claudicatio intermittens – Anspruch und Wirklichkeit

Zusammenfassung

Die narrative Übersichtsarbeit fasst die Studienlage zum Thema Gehtraining bei Patienten mit Claudicatio intermittens (CI) zusammen. Eindringlich wird auf die evidenzbasierten Leitlinienempfehlungen und die dahinterstehenden Studien eingegangen. Aspekte zum angiomorphologischen Befund, zu Patientenadhärenz, Langzeitwirkung, Studienqualität und ihre Vergleichbarkeit werden diskutiert. Der Problematik in der Versorgungsrealität mit Abweichungen von den Leitlinien und der oftmals invasiven Erstlinientherapie des PAVK-IIb-Patienten werden besondere Bedeutung geschenkt. Dabei wird die Rolle des Rehasports und die gesundheitspolititsche Bedeutung von Gehtraining in Deutschland erörtert. Gründe für die fehlende Leitlinientreue und deren Umsetzung im Gesundheitssystem werden analysiert. Dementsprechend werden Handlungsempfehlungen, in Anlehnung an internationale Erfahrungen (Niederlande, Dänemark), zur Besserung der Situation in Deutschland formuliert.

Abstract

This narrative review summarizes the situation of research concerning exercise therapy in patients suffering from intermittent claudication. In depth we present the evidence-based guidelines and their underlying studies. Aspects as angiomorphology, adherence, long-term effect, quality of studies and their comparability are discussed. We focus on the gap between guidelines and therapy of healthcare providers. Therefore, we discuss the relevance of exercise therapy in healthcare policy. Reasons for the missing congruence between guidelines and the implementation in the healthcare system in Germany are analysed. According to this we express recommendations corresponding to international experiences (Netherlands, Denmark).

Schlüsselwörter

periphere arterielle Verschlusskrankheit - überwachtes Gehtraining - evidenzbasierte Medizin

Keywords

peripheral arterial occlusive disease - supervised exercise therapy - evidence based medicine

• Literatur

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