Physiotherapy for PAD: How you can improve your blood circulation
Peripheral arterial occlusive disease (PAD) is a disease in which the arteries that transport blood to the legs and arms are narrowed or blocked. This leads to reduced blood flow to the muscles and organs, which can result in pain, wound healing disorders or even tissue loss. PAD is also known as intermittent claudication because sufferers often have to stand still to relieve the pain.
PAD is a consequence of arteriosclerosis, i.e. the deposition of fat and calcium in the vessel walls. The most important risk factors for the development of PAD are smoking, high blood pressure, diabetes, high blood lipids and lack of exercise. PAD cannot be cured, but with consistent treatment, the progression of the disease can be slowed or stopped.
The treatment of PAD includes drug therapy, vascular surgery or interventional procedures such as balloon dilatation or stent implantation. Physiotherapy also plays an important role, however, as it promotes blood circulation, relieves pain and improves quality of life.
What is the aim of physiotherapy for PAD?
The aim of physiotherapy for PAD is to increase the patient's physical performance and resilience by strengthening the muscles and increasing endurance. This improves the oxygen supply to the tissues and stimulates the formation of new blood vessels that can bypass the narrowed or blocked arteries. These so-called collaterals can significantly improve the circulation situation and reduce the symptoms.
Physiotherapy for PAD consists of two main elements: gait training and special gymnastics.
How does gait training work with PAD?
Walking training is one of the most effective methods for treating stage II PAD, i.e. when patients experience pain when walking. Walking training consists of regular walks with short breaks during which the pain threshold is tested. This means that patients should walk until they feel mild to moderate pain, then take a short break and then continue walking. This cycle should be repeated several times until a total walking time of 30 to 40 minutes is reached.
Walking training should be carried out at least three to four times a week, ideally daily. The intensity and duration of walking training should be individually adapted and gradually increased. Care should always be taken to maintain good posture and an even breathing rhythm.
Walking training has several positive effects on PAD: it improves oxygen uptake and utilization in the muscles, it promotes the formation of collaterals, it lowers blood pressure and blood sugar, it reduces body weight and the risk of heart attack and stroke.
What are the special exercises for PAD?
Special gymnastics for PAD complements gait training and aims to strengthen the muscles of the legs, maintain or improve joint mobility and train coordination and balance. The exercises should be performed before or after gait training and last around 15 to 20 minutes.
The exercises can be performed standing, sitting or lying down. All major muscle groups in the legs should be used, such as the calf, thigh and buttock muscles. The exercises should be performed slowly and in a controlled manner, without jerky or fast movements. The number of repetitions and the intensity of the exercises should be individually adapted and gradually increased.
Special gymnastics for PAD has several positive effects on PAD: it improves muscle strength and endurance, it increases flexibility and joint health, it improves body awareness and self-confidence.
What are the most common forms of PAD?
PAD can be divided into four stages, depending on how severe the circulatory disorder is and which symptoms occur.
- Stage I: Patients have no symptoms, even during physical exertion. The blood flow is still sufficient, but the first changes in the vessels can already be detected.
- Stage II: Patients have pain when walking, forcing them to stop. Blood flow is no longer sufficient under stress, but is still normal at rest. This stage is also known as intermittent claudication or intermittent claudication.
- Stage III: Patients have pain at rest, especially at night or when lying down. The blood flow is no longer sufficient even at rest; there is critical ischemia. This stage is also referred to as pain at rest.
- Stage IV: Patients have tissue loss or necrosis in the toes, feet or lower legs. The blood supply is so severely restricted that the tissue dies. This stage is also known as gangrene.
PAD can take different forms depending on the localization of the vascular constriction or occlusion. The most common forms are
- Pelvic-leg type: The narrowing or blockage affects the arteries in the pelvis or legs. This is the most common form of PAD, accounting for around 90 percent of cases.
- Arm type: The narrowing or blockage affects the arteries in the arms. This is a rare form of PAD, accounting for around 5 percent of cases.
- Abdominal type: The narrowing or occlusion affects the arteries in the abdomen, such as the renal arteries or the mesenteric arteries. This is a very rare form of PAD, accounting for around 1 percent of cases.
Conclusion
Physiotherapy is an important part of the treatment of PAD patients, especially in stage II. Through regular walking training and special gymnastics, patients can improve their blood circulation, relieve their pain and improve their quality of life. Physiotherapy should always be carried out in consultation with the attending physician and adapted to the patient's individual needs and goals.
PAD is a serious disease that can not only lead to discomfort in the legs, but also increases the risk of heart attack and stroke. It is therefore important to reduce the risk factors for arteriosclerosis, such as smoking, high blood pressure, diabetes or obesity. A healthy diet, regular check-ups and drug therapy can slow down the progression of PAD.