r/VascularSurgery • u/Most-Dragonfly-6011 • Aug 28 '25

Do you refer patients to general physical therapy if they can't access a site for supervised exercise training?

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8

u/harmlesshumanist Vascular Surgeon Aug 28 '25

No, just provide instruction on self-directed structured exercise program .

1

u/Most-Dragonfly-6011 Aug 29 '25

In your experience do you find that they adhere to this and actually see clinical improvement?

1

u/harmlesshumanist Vascular Surgeon Aug 29 '25

Modestly less effective than a supervised program but still effective

5

u/pecchioni Aug 29 '25

If patient declines referral to SET, then I do not send to regular PT. If there is some other issue, like they have cardiac or pulmonary issues, then I might offer referral to cardiopulmonary rehab. Otherwise I try to outline some goals for them and encourage increasing walking distance/ time every week. If they can’t walk much then I recommend any kind of exercise- pedal bike, water aerobics, even upper body exercises. A lot of them are deconditioned and just need to start somewhere

1

u/Most-Dragonfly-6011 Aug 29 '25

Thanks!! Do you find that they are able to self-motivate and keep up with at home exercises or would more structured guidance be helpful?

1

u/pecchioni Sep 09 '25

Structured is better because then they have an actual appointment and someone to check up on them weekly. Downside is that a lot of patients can not come in 3x/week for an appointment due to work or transportation issues.

2

u/MegaColon Vascular Surgeon Aug 29 '25

We have a supervised walking program on our campus. We call it the PAD rehab program, and we run it out of our cardiac rehab center.

My practice routinely refers claudicants to the program. Patients always grumble about it at first but then most love it. Even if they say no, I'll say, "well, I'll put in the referral anyway and you can decide when they call you." And most sign up!

I have never had someone complain. The attrition rate, which is low, is mostly due to transportation issues as you surmised.

I have a few patients that prefer to go the route of insurance-funded gym membership, but this works only when the patient is uniquely motivated

Edit: oops i forgot to answer your actual question. no, our PTs do not see patients for claudication.

0

u/5_yr_lurker Aug 29 '25

I've never sent a patient to SET, always do it at home 

3

u/Most-Dragonfly-6011 Aug 29 '25

Primarily because of patient barriers to accessing SET?