Exercise therapy under the supervision of a physiotherapist is successful as a first step in the treatment of so-called display legs, a vascular disease that is characterized by a lot of pain in the legs. Thanks to this ‘supervised gait training’, the number of patients who ultimately require angioplasty or surgery is reduced. This is reported by the National Health Care Institute.
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In the report ‘Final evaluation of Peripheral Arterial Disease’, the National Health Care Institute concludes that care providers and patient associations have succeeded in providing more appropriate care to people with display legs. The standard treatment for display legs was always a referral by the general practitioner to a vascular surgeon for treatment. In 2016, health care providers, patient associations and health insurers, led by the Zorginstituut, established that a surgical procedure is usually not the most appropriate treatment for the patient. This has led to several improvement agreements on the basis of which healthcare has been organized differently in recent years.
Most new patients receive walking training
The GP is now the director who makes the diagnosis and then coordinates the care for patients. Supervised gait training is the first step. Surgical intervention is now only considered if the gait training has no effect. Meanwhile, 86 percent of all new patients receive supervised gait training, the target is 95 percent. The use of gait training as the first treatment step leads to a significant reduction in the number of operations, and thus to a saving of almost 31 million euros per year. Supervised gait training has been insured care since the beginning of 2017.
Unhealthy lifestyle and hereditary predisposition
Peripheral arterial disease (PAD) is caused by hardening of the arteries in the arteries to the legs. This vasoconstriction causes pain when walking. Many people with PAD disguise their pain when walking by standing still in front of shop windows. The disease is therefore referred to as ‘shop windows’. In the Netherlands, an estimated 85,000 people suffer from display legs. The majority of this group suffers from exercise complaints. In 10 to 20 percent of people, the complaints worsen within 5 years. Of them, 5 to 10 percent develop such problems that walking becomes almost impossible. PAD usually occurs from the age of 40. An unhealthy lifestyle, such as smoking, and a genetic predisposition to cardiovascular disease are risk factors, in addition to high blood pressure and high blood cholesterol.
By: National Care Guide
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