Peripheral arterial disease and intermittent claudication: Efficacy of short term upper body strength training, dynamic exercise training, and advice to exercise at home

Abstract

Objective: To compare 2 training programmes and advice to exercise at home on physiological adaptations in patients with peripheral arterial disease (PAD).
Design: 30 patients with a typical history of PAD and intermittent claudication randomised to either a upper body strength training programme (UBST), dynamic (walking, cycling, circuit) conventional exercise rehabilitation programme (CER) or advice to walk as “much as possible” at home (CONT).
Before and after intervention groups performed a standard graded treadmill exercise test (GTET) and a 6 minute walk test (SMWT) to determine peak physiological parameters and walking distances. Maximal walking distance (MWD), pain free walking distance (PFWD), VO2peak, heart rate and perceived pain were measured.
Results: MWD on the GTET increased significantly in the CER group compared to the CONT and UBST group [93.9 ±79 vs 7.0 ±19.8 vs 7.3 ±46 %; CER vs UBST vs CONT P=0.003]. Similarly VO2peak increased with CER compared to the CONT and UBST group [28.4 ±20 vs. -6.2 ±15 vs -1.0 ±21 %; CER VS UBST vs CONT P=0.004]. During the SMWT the CER and UBST group improved in PFWD compared to the CONT group [37 ±47 vs 27 ±71 vs -30 ±29 %; CER vs UBST vs CONT P=0.03] and perceived pain decreased in the CER group compared to the UBST group [-24 ±39 vs 27±48 %; CER vs UBST P=0.01].
Conclusion: CER improves physiological parameters and walking distances more than UBST does. CER is effective within 6 weeks. Verbal encouragement to exercise is an ineffective form of management.