{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:17:35Z","timestamp":1784125055141,"version":"3.55.0"},"reference-count":62,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Spanish Ministry of Universities","award":["FPU20\/07594"],"award-info":[{"award-number":["FPU20\/07594"]}]},{"name":"Spanish Ministry of Universities","award":["FPU19\/02117"],"award-info":[{"award-number":["FPU19\/02117"]}]},{"name":"Spanish Ministry of Economy and Competitiveness and Fondos FEDER"},{"name":"Fondo de Investigaciones Sanitarias [FIS]","award":["PI18\/00139"],"award-info":[{"award-number":["PI18\/00139"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>This systematic review aims to evaluate and summarize findings from published meta-analyses on the effects of regular exercise in patients with peripheral arterial disease (PAD). The review will assess the impact of exercise on functional parameters, health-related quality of life, haemodynamic parameters, physical activity levels, adverse events, and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A systematic search was performed in PubMed, Web of Science, Scopus, and Cochrane Library databases (up to May 2023) to identify meta-analyses including randomized controlled trials that examined the effects of regular exercise in patients with PAD. Sixteen studies, with a total of 198 meta-analyses, were identified. Results revealed with strong evidence that patients with PAD who exercised improved functional and health-related quality of life parameters. Specifically, supervised aerobic exercise (i.e. walking to moderate\u2013maximum claudication pain) improves maximum walking distance [mean difference (MD): 177.94 m, 95% confidence interval (CI) 142.29\u2013213.60; P &amp;lt; 0.00001; I2: 65%], pain-free walking distance (fixed MD: 68.78 m, 95% CI 54.35\u201383.21; P &amp;lt; 0.00001; I2: 67%), self-reported walking ability [i.e. distance score (MD: 9.22 points, 95% CI 5.74\u201312.70; P &amp;lt; 0.00001; I2: 0%), speed score (MD: 8.71 points, 95% CI 5.64\u201311.77; P &amp;lt; 0.00001, I2: 0%), stair-climbing score (MD: 8.02 points, 95% CI 4.84\u201311.21; P &amp;lt; 0.00001, I2: 0%), and combined score (MD: 8.76 points, 95% CI 2.78\u201314.74; P &amp;lt; 0.0001, I2: 0%)], aerobic capacity (fixed MD: 0.62 mL\/kg\/min, 95% CI 0.47\u20130.77, P &amp;lt; 0.00001, I2: 64%), and pain score (MD: 7.65, 95% CI 3.15\u201312.15; P = 0.0009; I2: 0%), while resistance exercise improves lower limb strength (standardized mean difference: 0.71, 95% CI 0.29\u20131.13, P = 0.0009; I2: 0%]. Regarding other outcomes, such as haemodynamic parameters, no significant evidence was found, while physical activity levels, adverse events, and mortality require further investigation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Synthesis of the currently available meta-analyses suggests that regular exercise may be beneficial for a broad range of functional tasks improving health-related quality of life in patients with PAD. Supervised aerobic exercise is the best type of exercise to improve walking-related outcomes and pain, while resistance exercise is more effective to improve lower limb strength.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwad261","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T19:34:41Z","timestamp":1692819281000},"page":"380-388","source":"Crossref","is-referenced-by-count":20,"title":["Winners do what they fear: exercise and peripheral arterial disease\u2014an umbrella review"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5820-4925","authenticated-orcid":false,"given":"Sa\u00fal","family":"Pe\u00f1\u00edn-Grandes","sequence":"first","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-8239","authenticated-orcid":false,"given":"Susana","family":"L\u00f3pez-Ortiz","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-5636","authenticated-orcid":false,"given":"Sergio","family":"Maroto-Izquierdo","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4732-9802","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Men\u00e9ndez","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8179-9253","authenticated-orcid":false,"given":"Jos\u00e9","family":"Pinto-Fraga","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-1061","authenticated-orcid":false,"given":"Juan","family":"Mart\u00edn-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-7858","authenticated-orcid":false,"given":"Simone","family":"Lista","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5565-0997","authenticated-orcid":false,"given":"Alejandro","family":"Lucia","sequence":"additional","affiliation":[{"name":"Research Institute of the Hospital 12 de Octubre (\u2018imas12\u2019 and \u2018PaHerg group\u2019) , Madrid , Spain"},{"name":"Faculty of Sport Sciences, Universidad Europea de Madrid , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2309-3583","authenticated-orcid":false,"given":"Alejandro","family":"Santos-Lozano","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC) , Padre Julio Chevalier Street, 2, 47012, Valladolid, Castilla y Le\u00f3n , Spain"},{"name":"Research Institute of the Hospital 12 de Octubre (\u2018imas12\u2019 and \u2018PaHerg group\u2019) , Madrid , Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,23]]},"reference":[{"key":"2024030501225968900_zwad261-B1","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1056\/NEJMcp1507631","article-title":"Clinical practice. 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