title: Exercise training for claudicants: changes in blood flow, cardiorespiratory status, metabolic functions, blood rheology and lipid profile.
abstract: OBJECTIVE
  Exercise training improves the walking distance of claudicants. The aim of this study was to investigate factors associated with the improvement in the maximum walking distance (MWD) in respect to cardiovascular, respiratory and metabolic adaptations.
  
  
  METHODS
  Forty claudicants were studied. Common femoral artery blood flow (BF), heart rate (HR), oxygen consumption (VO(2)), respiratory exchange ratio (RER), lactate levels, blood rheology and lipid profiles were measured. Tests were repeated after 3 months of exercise training.
  
  
  RESULTS
  Fifteen patients did not complete the exercise program. For patients who did complete the program, MWD improved by 82%. A significant reduction in HR and VO(2)during exercise was demonstrated. No significant changes occurred in BF or RER. Although MWD increased significantly, there was no increase in recovery VO(2)(oxygen debt). A significant reduction in post-exercise lactate levels occurred. Blood rheology was unchanged, but an improvement in HDL levels was noted.
  
  
  CONCLUSIONS
  Many claudicants could not complete an exercise program, mainly due to osteoarthritis. Exercise training improved exercise tolerance significantly without any increase in BF. The HR and oxygen cost of similar exercise was reduced. An improved MWD did not correlate with a higher oxygen debt or lactate load. Favourable changes in lipid profiles occurred.
authors.affiliation: Department of Vascular Surgery, Countess of Chester Hospital, U.K.
authors.forename: K H
authors.initials: KH
authors.lastname: Tan
authors.forename: D
authors.initials: D
authors.lastname: Cotterrell
authors.forename: K
authors.initials: K
authors.lastname: Sykes
authors.forename: G R
authors.initials: GR
authors.lastname: Sissons
authors.forename: L
authors.initials: L
authors.lastname: de Cossart
authors.forename: P R
authors.initials: PR
authors.lastname: Edwards
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D008076:Cholesterol, HDL / Q000097:blood; D004734:Energy Metabolism / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000534:rehabilitation*; D007511:Ischemia / Q000503:physiopathology / Q000534:rehabilitation*; D019344:Lactic Acid / Q000097:blood; D007866:Leg / Q000098:blood supply*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D016896:Treatment Outcome
chemical_list: D008076:Cholesterol, HDL; D008055:Lipids; D019344:Lactic Acid; D010100:Oxygen