Endurance Exercise Training in Patients With Small Abdominal Aortic Aneurysm: A Randomized Controlled Pilot Study

High-intensity interval exercise training before abdominal aortic aneurysm repair (HIT-AAA): protocol for a randomised controlled feasibility trial

“…Kothmann et al 19 reported a 10% increase in the oxygen consumption at the ventilatory threshold (a submaximal marker of cardiopulmonary fitness of prognostic significance) after 6 weeks of moderate-intensity cycling exercise performed for 30 min twice weekly. Tew et al 20 observed a 2.5 mL/kg/min (∼20%) improvement in the ventilatory threshold after 12 weeks of moderate-intensity cycling and treadmill walking exercise performed for 35–45 min thrice weekly. A recent review of pre-operative exercise training21 proposed a research agenda, with future directions including the role of prehabilitation in improving fitness levels prior to major surgery, the use of robust study designs with appropriate outcome measures and evaluations of the effects of high-intensity interval exercise training (HIT) as a model for which there is extensive evidence of benefit in other patient groups, including patients with heart failure 22.…”

A Controlled Trial of the Efficacy of a Training Walking Program in Patients Recovering from Abdominal Aortic Aneurysm Surgery

“…This consists of a detailed cardiological evaluation, surgery assessment and dedicated physiotherapy. Exercise stress tests as well as a lung function test are important elements in the pre-surgery evaluation in [18,19]. It is well known that antithrombotic modalities and lower limb exercises, performed after abdominal surgery, facilitate venous blood return and additionally are a substitute for abdominal muscle exercises.…”

Patient recruitment and experiences in a randomised trial of supervised exercise training for individuals with abdominal aortic aneurysm

“…2 Unfortunately, there are currently few treatment options available for inhibiting 6 AAA expansion in individuals with small AAA (30 to 49 mm); 2,3 most patients simply enter a 7 surveillance programme to monitor the progression of their aneurysm. Recently, there has been a 8 growing interest in the role of exercise training in reducing AAA progression and increasing 9 fitness for surgery in individuals with small AAA; [4][5][6] however, no previous studies have provided 10 detailed information about the effectiveness of recruitment strategies. Patient recruitment into 11 randomised controlled trials is recognised as one of the most difficult aspects of the study 12 process since it can be costly and time consuming.…”

“…6 Recruitment to this study was difficult with uptake <50% of our 20 original target. The purpose of this paper is twofold: (i) to provide a detailed report of our 21 recruitment strategies and results with a view to informing recruitment in future trials in this area, 22 session with the Consultant Vascular Surgeon for further medical examination.…”

“…Current evidence (mostly indirect) from both human and animal studies suggests that it is 11 unlikely that chronic exercise training will reduce the size of an aneurysm, but it might inhibit 12 aneurysm development and reduce the rate of aneurysm progression. 5,6,[11][12][13] The group's 13 reflections suggest that this detailed type of knowledge and information is not being 14 communicated to patients and thus there is a need for tailored exercise advice whereby likely 15 benefit should be made explicit. This, however, might be difficult at present considering that the 16 role of exercise training in the management of AAA disease and the optimal exercise 17 prescription for this population are yet to be clearly defined.…”