Use of electromyostimulation or shock wave therapy as an adjunctive therapy for patients with peripheral arterial occlusive disease

Peripheral arterial occlusive disease (PAD) is a restriction of blood flow in the arteries supplying the extremities, usually due to arteriosclerosis. Depending on the stage and symptoms, the patient's pain-free walking distance is reduced to < 200 metres. The restriction in mobility is determined by the severity of the claudication symptoms (intermittent claudication [CI] caused by pain and limping, depending on the degree of stenosis).

As both PAD and coronary heart disease (CHD) have a common aetiology (atherosclerosis), the risk of PAD patients for cardiovascular (heart attack) and neurovascular (stroke) events is significantly increased. The main aim of rehabilitation for PAD patients is to alleviate functional disorders caused by reduced arterial blood flow in the legs and to reduce mobility restrictions caused by the disease. By effectively alleviating the symptoms already during inpatient rehabilitation, an increase in physical activity and participation in rehabilitation sports can also be achieved.

The aim of this project proposal is therefore to investigate methods for improving the clinical picture and physical performance of PAD patients. Scientific findings in recent years suggest that both electromyostimulation (EMS) and shock wave therapy (SWT) can potentially improve endothelial function and microvascular tissue perfusion. This is important as both parameters influence the arterial blood flow to the extremities and can therefore increase physical performance.

For PAD patients, improved endothelial function and tissue perfusion mean a longer (pain-free) walking distance and greater overall physical resilience. The use of EMS and SWT has hardly been investigated, especially in inpatient rehabilitation, and the physiological effects of both therapies have so far been poorly described in PAD patients. We assume that EMS or SWT leads to an improvement in blood flow to the extremities, which can have a positive influence on the course of treatment for PAD patients. Based on the expected findings, future treatment successes of PAD patients could also be significantly increased across the board. Two randomised controlled intervention studies are being carried out to test this.