Amy Elizabeth Harwood

Amy Elizabeth Harwood
Coventry University | CU · Faculty of Health and Life Sciences

PhD, BASES

About

73
Publications
19,534
Reads
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844
Citations
Citations since 2016
69 Research Items
844 Citations
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Introduction
Assistant Professor in Clinical Exercise Physiology at Coventry University. Research focus in exercise and alternative therapies in clinical populations | Particular interest in patients with peripheral artery disease | BASES accredited sport and exercise scientist | Sn. Associate Editor BMJ Open Sport and Exercise Medicine | Associate Editor at Vascular Medicine | amy.harwood@coventry.ac.uk
Additional affiliations
October 2018 - present
The University of Sydney
Position
  • PostDoc Position
October 2017 - October 2018
Hull York Medical School
Position
  • PostDoc Position
October 2014 - October 2017
Hull York Medical School
Position
  • PhD Student, Vascular Scientist

Publications

Publications (73)
Article
Full-text available
Supervised exercise programmes are recommended by current UK guidelines as the first line treatment for patients with Intermittent Claudication (IC) and NICE guidelines state that all patients should be offered exercise as a treatment option. This survey study aimed to determine the current availability of exercise programmes in UK vascular centres...
Article
Full-text available
Objective: Intermittent claudication (IC) is frequently associated with deterioration in walking capacity and physical function, and it can often result in an impairment in balance. Whereas supervised exercise is recommended by the National Institute for Health and Care Excellence as the first-line treatment, the mechanism behind walking improveme...
Article
Background: Exercise programmes are a relatively inexpensive, low-risk option compared with other, more invasive therapies for treatment of leg pain on walking (intermittent claudication (IC)). This is the fourth update of a review first published in 1998. Objectives: Our goal was to determine whether an exercise programme was effective in allev...
Preprint
Full-text available
Background: Uptake and completion rates for supervised exercise programmes (SEP) for patients with intermittent claudication (IC) are low. Current exercise prescription is a one size fits all approach, based on claudication pain thresholds, potentially limiting individual benefits. High-intensity interval training (HIIT) has the potential to overco...
Article
Full-text available
Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with...
Article
Full-text available
Background Peripheral artery disease affects over 236 million people globally and the classic symptom is intermittent claudication (IC) which is associated with reduction in physical activity. The evidence that supervised exercise programmes (SEPs) improve pain-free and maximal walking distance is irrefutable. However, adherence rates are low with...
Article
Full-text available
Why we are undertaking the research: Peripheral artery disease is a common problem where the blood vessels in the legs are narrowed by fatty deposits. Supervised exercise programmes are recommended to help treat this condition, as they can reduce leg pain and improve fitness. However, not many people are able to access these programmes typically be...
Article
Full-text available
Plain English Summary Why we are undertaking the research: Peripheral artery disease is a common problem where the blood vessels in the leg are narrowed by fatty build-ups. These fatty deposits may restrict blood flow which causes pain during exercise and limits how far people can walk. To assess a patient’s maximal walking distance, clinicians may...
Article
Full-text available
New findings: What is the topic of this review? This review focuses on the physiological impact of abdominal aortic aneurysm (AAA) on cardiorespiratory fitness, and the negative consequences of low fitness on clinical outcomes in AAA. We also discuss the efficacy of exercise training for improving cardiorespiratory fitness in AAA. What advances do...
Article
Full-text available
Background Exercise therapy is an important treatment option for people with intermittent claudication (IC). Appropriate reporting of exercise interventions in populations with IC within randomised controlled trials (RCTs) is important to ensure that research can be translated into clinical practice. Therefore, the purpose of our review is to evalu...
Article
Full-text available
National Institute for Health and Care Excellence (NICE) guideline 147 recommends supervised exercise therapy (SET) for all patients with intermittent claudication, consisting of 2 hours of SET per week for a 3-month period.1 This is supported by good evidence from Cochrane reviews2,3 that SET shows improvement in mean walking performance compared...
Article
Full-text available
Intermittent claudication (IC) is a classic symptom of peripheral artery disease, with first line treatment being supervised exercise therapy (SET). Despite this, SET is frequently underutilised, and adherence is often poor. An alternative option are home-based exercise programmes (HBEP). Although HBEPs are well tolerated, to the authors’ knowledge...
Article
Introduction: Peripheral arterial disease (PAD) is a common health problem associated with reduced mobility, functional capacity and quality of life. Significant research exists in the field of vascular surgery, but its relevance to the research priorities of patients/carers and clinicians/healthcare professionals is unknown. The aim of this proces...
Article
Full-text available
Background: There is wide discrepancy in how published research defines and reports home-based exercise programmes. Studies consisting of fundamentally different designs have been labelled as home-based, making searching for relevant literature challenging and time consuming. This issue has been further highlighted by an increased demand for these...
Article
Full-text available
Objectives Supervised exercise programmes (SEPs) are a vital treatment for people with intermittent claudication, leading improvements in walking distance and quality of life and are recommended in multiple national and international guidelines. We aimed to evaluate the use and structure of SEPs in the United Kingdom (UK). Design We conducted an a...
Article
Background Current guidelines for intermittent claudication advocate exercise at moderate to maximal claudication pain. However, adherence rates to supervised exercise programmes (SEP) remain poor and claudication pain is a contributing factor. Limited evidence suggests that moderate or pain-free exercise may be just as beneficial and may be better...
Article
Full-text available
A large body of research supports the use of exercise to improve symptoms, quality of life, and physical function in patients with chronic heart failure. Previous reviews have focused on reporting outcomes of exercise interventions such as cardiorespi-ratory fitness. However, none have critically examined exercise prescription. The aim of this revi...
Article
Objectives Supervised exercise programmes (SEP) are effective for improving walking distance in patients with intermittent claudication (IC) but provision and uptake rates are sub-optimal. Access to such programmes has also been halted by the Coronavirus pandemic. The aim of this review is to provide a comprehensive overview of the evidence for hom...
Article
Full-text available
Prolonged lockdown/restriction measures due to the COVID-19 pandemic have reportedly impacted opportunities to be physically active for a large proportion of the population in affected countries globally. The exact changes to physical activity and sedentary behaviours due to these measures have not been fully studied. Accordingly, the objective of...
Article
Full-text available
A systematic review was conducted to identify the range of terminology used in studies to describe maximum walking distance and the exercise testing protocols, and testing modalities used to measure it in patients with intermittent claudication. A secondary aim was to assess the implementation and reporting of the exercise testing protocols. CINAHL...
Article
Full-text available
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 / PubM...
Article
Full-text available
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. The clinical presentation of this virus mainly manifests in the respiratory system but may also lead to severe complications in the cardiovascular system. The global burden of COVID-19 has led to an unprecedented need to gain further insight into patie...
Article
Purpose: This study assessed the feasibility, tolerability, safety, and potential efficacy of a novel, 6-wk, high-intensity interval training (HIIT) program for patients with intermittent claudication (IC). Methods: Patients referred to a usual-care supervised exercise program were invited to undertake a HIIT program. All recruited patients perf...
Article
Background: Lower limb peripheral arterial disease (PAD) is a type of cardiovascular disease where the blood vessels that carry the blood to the legs are hardened and narrowed. The most severe manifestation of PAD is critical limb ischaemia (CLI). This condition results in symptoms of intractable rest pain, non-healing wounds and ulceration, gangr...
Article
Full-text available
Introduction The first-line recommended treatment for patients with intermittent claudication (IC) is a supervised exercise programme (SEP), which includes a minimum of 2-hours of exercise per week over a 12-week period. However, provision, uptake and adherence rates for these SEP programmes are poor, with time constraints cited as a common partici...
Poster
Full-text available
A poster outlining the findings of an interventional cohort study considering the feasibility, safety and tolerability of high-intensity interval training for patients with intermittent claudication. This poster outlined the findings from our first cohort of 20 patients.
Article
Full-text available
Purpose To assess whether ad libitum water ingestion of different temperatures is sufficient to prevent dehydration-related exacerbations of thermal and cardiovascular strain, during exposure to conditions representative of a heatwave. Methods Twelve participants (mean ± SD; 25 ± 4 years) exercised for 180 min at 3 METs in 40.1 ± 0.6 °C, 40.4 ± 2....
Presentation
Presenting the findings from the first 20 recruits to our interventional cohort study considering the feasibility, safety and tolerability of high-intensity interval training for patients with intermittent claudication.
Article
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness of prehabilitation (preoperative exercise, either alone or in combination with nutritional or psychological interventions or both) on postoperative outcomes in adults with PAD undergoing open lower limb surgery. © 2019 The Cochrane Co...
Article
Background: Intermittent claudication (IC) is the most common symptom of peripheral arterial disease, which significantly affects walking ability, functional capacity and quality of life. Supervised exercise programs (SEP) are recommended as first-line treatment, but recruitment and adherence rates are poor. The time required to complete a SEP is...
Article
Full-text available
A surgical site infection (SSI) may occur in up to 30% of procedures and results in significant morbidity and mortality. We aimed to assess the feasibility of conducting a randomised controlled trial (RCT) examining the use of dialkylcarbamoylchloride (DACC)‐impregnated dressings, which bind bacteria at the wound bed, in the prevention of SSI in pr...
Article
Full-text available
Background Surgical site infection in vascular surgery has a reported incidence of up to 19%. A novel method of reducing this rate of infection is dressings coated with dialkylcarbamoylchloride (DACC), a hydrophobic wound contact layer that binds bacteria and removes them from the wound bed. Early research has suggested that DACC-coated wound dress...
Article
Background Mechanochemical ablation is an innovative non-thermal method of treating symptomatic axial superficial venous incompetence. This is a single-centre cohort study aiming to investigate the technical efficacy and clinical effectiveness at one year. Methods Patients with primary, unilateral, symptomatic axial incompetence were offered treat...
Data
Appendix_1 – Supplemental material for Home-based exercise programmes for individuals with intermittent claudication: A protocol for an updated systematic review and meta-analysis
Data
Appendix_2_Sample_data_collection_sheet – Supplemental material for Home-based exercise programmes for individuals with intermittent claudication: A protocol for an updated systematic review and meta-analysis
Article
Full-text available
Background The aim of this updated review is to consider the evidence base for the effectiveness of home-based exercise programmes as a treatment option for improving walking distance in patients with intermittent claudication. Methods The Medline, EMBASE, CINAHL, PEDro and Cochrane CENTRAL databases will be searched for terms including ‘intermitt...
Article
Abstract Objective Intermittent claudication occurs in 20% of the population older than 70 years, and treatment includes a supervised exercise program (SEP). Whereas there is evidence demonstrating walking improvements after an SEP, there are conflicting data on the physiologic changes behind this. This study aimed to explore and to identify the po...
Article
Full-text available
Background Patients with abdominal aortic aneurysms (AAAs) often have low exercise tolerance due to comorbidities and advanced age. Cardiopulmonary exercise testing (CPET) is predictive of postoperative morbidity and mortality in patients with AAA. We aimed to assess the intrarater and interrater reliability of both treadmill-based and cycle ergome...
Article
Background: Diabetes mellitus is one of the most common chronic diseases worldwide. Diabetic foot ulcers (DFUs) occur in over 10% of diabetic patients and are associated with high morbidity. Clinical trials have shown benefit from extracorporeal shockwave therapy (ESWT) in a DFU healing. This systematic review aims to assess the currently availabl...
Article
Full-text available
Background: Varicose veins impair quality of life and can lead to chronic leg ulcers. National Institute for Health and Care Excellence (NICE) guidelines (CG168) set out evidence-based standards for patient management. In England, Clinical Commissioning Groups (CCGs) fund NHS care within their locality. The objective of this study was to evaluate C...
Article
Background Clinical guidelines recommend endovenous laser ablation (EVLA) over surgery based on short‐term evidence, yet there are few studies reporting mid‐ to long‐term outcomes. The aim of this study was to report the 5‐year outcomes from an RCT of surgery versus EVLA for treatment of symptomatic great saphenous varicose veins. Methods Patients...
Article
Full-text available
Objectives Peripheral arterial disease most commonly presents as intermittent claudication (IC). Early evidence has suggested that extracorporeal shockwave therapy is efficacious in the short term for the management of intermittent claudication. The objective of this pilot trial was to evaluate the medium-term efficacy of this treatment. Methods Th...
Article
Full-text available
Objective: This study aims to assess whether a clinician reviewing photographs of a wound was an acceptable substitute for clinical review in order to identify or exclude surgical site infection (SSI). Method: We undertook a mixed methods study consisting of a qualitative public involvement exercise and a prospective, non-randomised, single-centre...
Article
Full-text available
Conventional supervised exercise programs (SEPs) for claudicants are traditionally based on time-constrained, group-based structured programs usually at a hospital site. Uptake of an SEP is poor, despite the high-level evidence demonstrating its clinical effectiveness; therefore, alternative forms of exercise programs are needed which are more acce...
Conference Paper
Full-text available
We investigated the impact of wearing a forced-air-ventilation system built-into body armour (13kg) on heat strain and thermal perceptions when 18 volunteers (1 female) exercised (60 minutes at 1.07 L.min-1 oxygen consumption) then rested (60 minutes) in 40°C, 20% RH air. We hypothesized that: heat strain would be reduced with constant air-ventilat...
Article
Full-text available
Background: Intermittent claudication is the most common symptom of peripheral arterial disease. Previous research has suggested that extracorporeal shockwave therapy (ESWT) may induce angiogenesis in treated tissue. The objective of this feasibility pilot trial was to assess the safety, tolerability, and efficacy of ESWT as a novel treatment. Me...
Article
Full-text available
Intermittent claudication (IC) is a common condition which has severe impacts on quality of life, physical function, and mental health. Supervised exercise is the recommended first-line treatment for patients with this condition; however, these are not always feasible or accessible to patients. As the proportion of patients who have this treatment...
Article
Introduction Lower limb peripheral arterial disease (PAD) affects 20% of population over 65 years. Extracorporeal Shockwave Therapy (ESWT) has recently emerged as a novel, safe and effective treatment option. This review aims to assess the mechanism of action by which ESWT improves symptoms in patients with PAD. Methods Medline and Embase database...
Data
Access to supervised exercise services for peripheral vascular disease patients Which factors determine the current provision of supervised exercise in the UK?. AE Harwood JOB TITLE GE Smith JOB TITLE E Broadbent JOB TITLE T Cayton JOB TITLE D Carradice JOB TITLE IC Chetter JOB TITLE Hull Royal Infirmary, Hull, UK PeerRev 18 ReseaRch PeerRev
Article
Full-text available
Background Intermittent claudication (IC) is a common condition that causes pain in the lower limbs when walking and has been shown to severely impact the quality of life (QoL) of patients. The QoL is therefore often regarded as an important measure in clinical trials investigating intermittent claudication. To date, no consensus exits on the type...
Article
Full-text available
Introduction: Dialkylcarbomoylchloride (DACC) coated dressings irreversibly bind bacteria at the wound surface that are then removed when the dressing is changed. They are a recent addition to the wound care professionals’ armamentarium and have been used in a variety of acute and chronic wounds. This systematic review aims to assess the current ev...
Article
Full-text available
Background Peripheral arterial disease (PAD) has a population prevalence of 4.6% with intermittent claudication (IC) presenting as one of the earliest and most common symptoms. PAD has detrimental effects on patients’ walking ability in terms of maximum walking distance (MWD) and pain-free walking distance (PFWD). Research has suggested extracorpor...