PT  - JOURNAL ARTICLE
AU  - Kahn, Susan R.
AU  - Shrier, Ian
AU  - Shapiro, Stan
AU  - Houweling, Adrielle H.
AU  - Hirsch, Andrew M.
AU  - Reid, Robert D.
AU  - Kearon, Clive
AU  - Rabhi, Khalil
AU  - Rodger, Marc A.
AU  - Kovacs, Michael J.
AU  - Anderson, David R.
AU  - Wells, Philip S.
TI  - Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial
AID  - 10.1503/cmaj.100248
DP  - 2011 Jan 11
TA  - Canadian Medical Association Journal
PG  - 37--44
VI  - 183
IP  - 1
4099  - http://www.cmaj.ca/content/183/1/37.short
4100  - http://www.cmaj.ca/content/183/1/37.full
SO  - CMAJ2011 Jan 11; 183
AB  - Background Exercise training may have the potential to improve post-thrombotic syndrome, a frequent, chronic complication of deep venous thrombosis. We conducted a randomized controlled two-centre pilot trial to assess the feasibility of a multicentre-based evaluation of a six-month exercise training program to treat post-thrombotic syndrome and to obtain preliminary data on the effectiveness of such a program. Methods Patients were randomized to receive exercise training (a six-month trainer-supervised program) or control treatment (an education session with monthly phone follow-ups). Levels of eligibility, consent, adherence and retention were used as indicators of study feasibility. Primary outcomes were change from baseline to six months in venous disease-specific quality of life (as measured using the Venous Insufficiency Epidemiological and Economic Study Quality of Life [VEINES-QOL] questionnaire) and severity of post-thrombotic syndrome (as measured by scores on the Villalta scale) in the exercise training group versus the control group, assessed by t tests. Secondary outcomes were change in generic quality of life (as measured using the Short-Form Health Survey-36 [SF-36] questionnaire), category of severity of post-thrombotic syndrome, leg strength, leg flexibility and time on treadmill. Results Of 95 patients with post-thrombotic syndrome, 69 were eligible, 43 consented and were randomized, and 39 completed the study. Exercise training was associated with improvement in VEINES-QOL scores (exercise training mean change 6.0, standard deviation [SD] 5.1 v. control mean change 1.4, SD 7.2; difference 4.6, 95% CI 0.54 to 8.7; p = 0.027) and improvement in scores on the Villalta scale (exercise training mean change −3.6, SD 3.7 v. control mean change −1.6, SD 4.3; difference −2.0, 95% CI −4.6 to 0.6; p = 0.14). Most secondary outcomes also showed greater improvement in the exercise training group. Interpretation Exercise training may improve post-thrombotic syndrome. It would be feasible to definitively evaluate exercise training as a treatment for post-thrombotic syndrome in a large multicentre trial.