{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T09:01:01Z","timestamp":1777712461013,"version":"3.51.4"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T00:00:00Z","timestamp":1730160000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:p>\n                    Intermittent claudication is a primary symptom of peripheral artery disease (PAD). a chronic progressive disease caused primarily by atherosclerosis. It is usually characterized by leg pain, aches, cramps, or fatigue when walking, which improves with rest. Physical therapy, including a supervised exercise program, is often recommended as the first treatment for sprains. This study aims to evaluate the short-term effects of incorporating heel raise and calf stretch exercises with standard medical therapy compared to medical therapy alone in managing intermittent claudication. From May 2022 to November 2023, 160 patients with Stage II Fontaine PAD were randomly assigned to two equal groups. Group A (80 patients) received heel raise and calf stretch exercises in addition to medical treatment, while Group B (80 patients) received only medical treatment. Both groups underwent treadmill walking tests before and after three months to measure absolute walking distance (ACD), peak walking time (PWT), and Walking Impairment Questionnaire (WIQ) scores, including distance, speed, and symptom severity. At baseline, there were no significant differences between the groups in terms of ACD, peak walking time, ankle-brachial index, distance, speed, and symptoms. At follow-up, Group A showed significantly greater improvements in ACD (312.00\u2009\u00b1\u200945.43\u2005m), peak walking time (8.54\u2009\u00b1\u20091.55\u2005min), distance (29.46\u2009\u00b1\u20094.63\u2005km), speed (20.01\u2009\u00b1\u20093.13 kph), and WIQ symptoms (22.10\u2009\u00b1\u20091.02) compared to Group B, which had ACD (276.55\u2009\u00b1\u200929.07\u2005m), peak walking time (6.72\u2009\u00b1\u20091.70\u2005min), distance (23.68\u2009\u00b1\u20093.89\u2005km), speed (15.71\u2009\u00b1\u20092.71 kph), and WIQ symptoms (20.80\u2009\u00b1\u20091.47) (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u2009.001). The ankle-brachial index remained similar between the groups (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&gt;\u2009.05). We concluded that integrating standard physical therapy exercises, such as calf raises and leg stretches, with medical therapy significantly enhances walking function in patients with ischemic intermittent claudication.\n                  <\/jats:p>","DOI":"10.1177\/15347346241294017","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T06:49:54Z","timestamp":1730184594000},"page":"647-654","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Heel Raises and Calf Stretches Exercises Versus Medication Only in Ischemic Intermittent Claudication: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2025-6172","authenticated-orcid":false,"given":"Mohammed Alsagheer","family":"Alhewy","sequence":"first","affiliation":[{"name":"Vascular and Endovascular Surgery department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelhfeez","family":"Moshrif","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdelaziz Ahmed","family":"Abdelhafez","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Hamza","family":"Metwaly","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehab Abd elmoneim","family":"Ghazala","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan","family":"Gado","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hany M","family":"Aly","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Badr Al-Amir","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Delta University for Science and Technology, Gamasa, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Abdelmoniem","family":"Negm","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed Atef","family":"Khamis","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael Abdo Abdo","family":"Abd-Elgawad","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Elsayed","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nehal","family":"Farouk","sequence":"additional","affiliation":[{"name":"Vascular and Endovascular Surgery Department, Faculty of Medicine (girls), Al-Azhar university, Cairo, Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,10,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.08.070"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.08.099"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.12.015"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2015.10.022"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.963066"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD005263.pub3"},{"issue":"12","key":"e_1_3_2_8_2","article-title":"Exercise for intermittent claudication","volume":"12","author":"Lane R","year":"2017","unstructured":"Lane R, Harwood A, Watson L, et al. Exercise for intermittent claudication. Cochrane Database Syst Rev. 2017;12(12):CD000990.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200434140-00004"},{"issue":"4","key":"e_1_3_2_10_2","article-title":"Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication","volume":"4","author":"Hageman D","year":"2018","unstructured":"Hageman D, Fokkenrood HJ, Gommans LN, et al. Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication. 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