Author(s): BIRKETT, S., DUFF, J., SARATZIS, A., BARTLETT, Y., HARWOOD, A., HAQUE, A., EDWARDS, H., Institution: MANCHESTER METROPOLITAN UNIVERSITY , Country: UNITED KINGDOM, Abstract-ID: 1452

INTRODUCTION:
Peripheral artery disease (PAD) affects over 236 million adults worldwide, with prevalence projected to rise by 50% by 2045. Chronic Limb-Threatening Ischaemia (CLTI) is the most severe form, characterised by rest pain and tissue loss, and accounts for ~11% of PAD cases. Despite urgent revascularisation, outcomes remain poor: one- and three-year mortality rates approach 50%, major adverse cardiovascular events occur in around 42% of patients, and major amputation rates can reach 20%. People with CLTI typically have reduced mobility, low physical fitness, high sedentary behaviour, and poor quality of life. While exercise therapy benefits those with intermittent claudication, its suitability for CLTI is unknown due to a lack of evidence. This study aimed to create a rehabilitation programme specifically for individuals with CLTI following revascularisation.
METHODS:
A modified Delphi study adopting a predefined framework of rehabilitation, exercise and education was conducted between November 2024 and June 2025. Round 1 consisted of open-ended questions distributed online and in paper format via email networks and social media to identify potential exercise and education components. In Round 2, participants rated and prioritised items; consensus was defined as ≥70% agreement. A final online workshop presented all findings, and items without consensus were discussed and re-evaluated through live voting.
RESULTS:
57 participants completed Round 1 (20 healthcare professionals; 37 individuals with CLTI/carers). Content analysis identified four exercise themes (activities, frequency, location, monitoring) and three education themes (content, delivery, timing). In Round 2, 29 participants (13 healthcare professionals; 16 individuals with CLTI/carers) completed ratings, achieving consensus on core exercise activities, including aerobic training, resistance training, and balance exercises, as well as consensus on key educational topics. In the final workshop (n=9; six healthcare professionals; three individuals with CLTI/carers), consensus was reached for all remaining items including exercise frequency, location and educational delivery methods.
CONCLUSION:
This study informed the creation of a novel, individualised rehabilitation programme for people with CLTI post-revascularisation. Future work will test the feasibility and acceptability of the programme.