Spurred by pedometers, unity and fun exercise: A qualitative study of participation in rehabilitation for patients with intermittent claudication (The CIPIC Rehab study)

AIM: To explore how patients with intermittent claudication experiences participating in a community-based cardiovascular rehabilitation program and the various components of the rehabilitation program.

BACKGROUND: Intermittent claudication is a condition associated with progressive atherosclerosis that affects daily life. Most patients with intermittent claudication do not exercise even though exercise is essential in the treatment of this condition. Rehabilitation is reported to be effective in alleviating symptoms, increasing walking distance, reducing cardiovascular events, and improving quality of life. Patients' perspectives are important when designing such programs, however, this aspect has not previously been investigated.

DESIGN: A qualitative study.

METHODS: Patients with intermittent claudication (n=10) participating in a rehabilitation program were interviewed in two focus groups. Pragmatic philosophy inspired the approach. Data were analyzed using qualitative thematic analysis, and emerging themes were discussed according to self-efficacy theory.

RESULTS: Participants experienced social support from other patients, which motivated them to exercise. The intervention encouraged the patients' management of leg pain, while a local setting and a pedometer were important motivational factors to keep adherence to the program. The participants' experiences of the rehabilitation program are expressed in four themes revealed from the qualitative analysis: 1) the shared community, 2) pushing your own limits, 3) spurred by pedometers and health professionals, and 4) continuing new habits on your own. The participants found the components in the rehabilitation program meaningful, but encountered difficulties in continuing on their own after completion of the program.

CONCLUSION: A specialized community-based cardiovascular rehabilitation program for patients with intermittent claudication can be supportive for patients suffering from intermittent claudication.

RELEVANCE TO CLINICAL PRACTICE: The qualitative results can be used to guide development of existing cardiac rehabilitation programs targeted patients with intermittent claudication in a community setting.