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Peripheral Vascular Disease Physiotherapy Management

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Peripheral vascular disease is narrowing of the vessels which supply oxygen rich blood to the peripheries due to blockage or obstruction. It most commonly affects the lower limbs. Peripheral vascular disease can significantly affect your ability to stand, walk or climb stairs. However, physiotherapy can help to increase the distance you are able to walk through muscle strengthening exercises, provision of mobility aids, appropriate orthotics and pain management. We deliver a high standard of physiotherapy intervention to those with peripheral vascular disease to improve your ability to complete normal activities of daily living and obtain a higher quality of life.


Symptoms of peripheral vascular disease

The symptoms of peripheral vascular disease include muscle crampingmuscle weakness, cold extremities and pain. The pain can be intermittent or persistent in nature and may accompany blue or pale limbs and reduced hair and nail growth on the affected limb. These symptoms can be mild and unnoticed or they can be severe and cause significant reductions in ability to move around and carry out a normal active life.

Causes of peripheral vascular disease

Peripheral vascular disease is caused by narrowing of the arteries that provide the blood supply to muscle and soft tissues of the limb. The narrowing is caused by a process called atherosclerosis. Atherosclerosis is the growth of fatty deposits and hardening of the arteries which prevent the blood from passing through the vessels smoothly. Factors which increase the risk of atherosclerosis and thus peripheral vascular disease include smoking, age, family history of heart disease or stroke, obesity and diabetes. Raised blood pressure and cholesterol can contribute to atherosclerosis therefore they should be controlled with anti-hypertension and statins. A lack of physical exercise is a modifiable risk factor which can be rectified with guidance and support from a physiotherapist.

Diagnosis of peripheral vascular disease

If peripheral vascular disease is suspected, your doctor will check your ankle brachial pressure index to check the blood pressure in your calf. If the readings are normal, they will carry out a Doppler ultrasound of the lower limb to look at the extent of atherosclerosis. Other imaging studies include angiography or computed tomography (CT) scan.

Treatment of peripheral vascular disease

Most of the symptoms of peripheral vascular disease can be reduced via modification of risk factors. Individuals with peripheral vascular disease are given smoking cessation advice, support to limit alcohol intake and encouragement to increase regular exercise. Blood pressure, cholesterol and glucose levels are tightly monitored to ensure specific safe target levels are maintained.

In severe cases of peripheral vascular disease, more invasive treatment options may be considered such as angioplasty or bypass surgery. Occasionally, the individual with peripheral vascular disease may require amputation of the limb.

Physiotherapy for peripheral vascular disease

An experienced physiotherapist from Physio.co.uk will carry out a detailed assessment of your symptoms and problems and suggest a treatment plan. Depending on your clinical presentation, treatment for peripheral vascular disease may include:
  • Pain management
  • Cardiovascular exercise
  • Sensory stimulation and massage
  • Muscle strengthening
  • Joint and muscle mobilisations
  • Mobility practice
  • Provision of walking aids and footwear advice
Treatment will be based on your problems and goals. A short term goal for an individual with peripheral vascular disease may be to walk to the corner shop with a stick or to climb the stairs twice daily with two handrails. Goals will be reviewed regularly and updated to ensure they are both challenging and achievable. It is important that physiotherapy sessions are goal- focused to maintain your motivation and enjoyment.

Your physiotherapist will provide you with an exercise program for you to complete in your own time at home. This will include a range of exercises which will work towards your goals. Exercises may include stretchesstrengthening workbalance activities and providing sensory stimulation to your hands and feet. It may be useful for a partner or relative to learn how to help you complete these exercises and how they can help you at home. Your physiotherapist will supply any equipment you may need to get around at home, for example a walking stick, frame or outdoor walker. Our colleagues at Manchester Podiatry and Manchester Occupational Therapy will be available to provide vascular assessment and advice regarding functional activities to those with peripheral vascular disease.

Individuals with peripheral vascular disease significantly benefit from regular physiotherapy treatment to minimise symptoms and reduce the risk of further complications. The benefits of physiotherapy for peripheral vascular disease include:
  • Increased mobility
  • Increased stamina and fitness
  • Increased muscle strength
  • Increased range of movement
  • Improved sensation
  • Decreased pain and muscle cramping
  • Decreased risk of further circulatory and cardiovascular problems
  • Decreased risk of falls
Our aim is to improve your mobility and ability to enjoy life. Our dedicated physiotherapists will strive to assess all aspects of peripheral vascular disease and if necessary, liaise with other health professionals involved in your care. With your consent, your physiotherapist will discuss medication with your doctor, footwear with your orthotist and the use of specialist equipment with your occupational therapist.
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