A systematic review of the role of heat therapy for patients with intermittent claudication due to peripheral artery disease

Amy Harwood, Christopher J A Pugh, Charles Steward, Campbell Menzies, C Douglas Thake, Tom Cullen

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    Intermittent claudication (IC) is associated with impairments in quality of life and walking ability. Heat therapy is an emerging cardiovascular therapy, which may improve walking in patients with IC. We undertook a systematic review to establish current evidence for heat therapy for patients with IC. We searched five databases (Ovid Medline / PubMed, Embase, Scopus / Web of Science, Cochrane Library and Health Technology Assessment Databases). A total of 6751 records were screened with 76 full-text articles assessed for eligibility. We included three randomised control trials and three acute interventions. For chronic interventions, three different heat therapy interventions were used. The 6-minute walk distance significantly improved following whole-body immersion (p = 0.03; ES 0.94, 95% CI: 0.06–1.82), but not after Waon therapy or a water-perfused garment. Ankle–brachial pressure indices were significantly improved following whole-body immersion (p = 0.01; ES 1.10, 95% CI: 0.20–1.99) but not after other therapies. No form of heat therapy demonstrated statistical improvements in quality of life or brachial blood pressure. Acute interventions were characterised by large increases in limb blood flow and core temperature, and transient reductions in blood pressure post-heating. At present there are only three randomised controlled trials assessing heat therapy for patients with IC. Moreover, each of those randomised controlled trials utilised different heat therapies. There is also very limited study of the acute physiological responses to different heat therapy interventions in these populations. Future research should establish appropriate heat therapy protocols and implement more randomised trials to understand its effectiveness. PROSPERO: CRD42020187941
    Original languageEnglish
    Pages (from-to)440-447
    Number of pages8
    JournalVascular Medicine
    Issue number4
    Early online date15 Feb 2021
    Publication statusPublished - 1 Aug 2021

    Bibliographical note

    This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).


    • heat therapy
    • intermittent claudication
    • peripheral artery disease (PAD)

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine


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