title: Exercise patterns and cardiovascular fitness of patients with peripheral arterial disease.
abstract: Peripheral arterial disease (PAD) is characterized by walking impairment as the result of claudication, which is improved by exercise. Few studies have examined the impact of existing exercise patterns in community-dwelling patients with PAD on cardiovascular fitness and absolute claudication distance (ACD). This descriptive study examines exercise patterns, walking distance, and cardiovascular fitness in a sample of community-dwelling older adults with PAD. Approximately 50% of subjects reported walking 4 (+/-2) days per week for 38 +/- 24 minutes. ACD (exercisers = 459.9 +/- 272; non-exercisers = 351.2 +/- 266.3, P = .06) and initial claudication distance (exercisers = 198.5 +/- 139.7; non-exercisers = 138.7 +/- 95.8 P = .02) were similar between groups. The workload accomplished was approximately 4.1-4.7 metabolic equivalents. Resting heart rate (HR) was associated with initial claudication distance ( r = -.37, P = .001) and ACD ( r = -.46, P < .01) and was lower in the group of exercisers versus the non-exercisers ( P = .05). Mean resting SBP was elevated and continued to increase at peak exercise with no difference between groups ( P = .75). Quality of life was poor for both groups. Simultaneous multiple regression analysis was performed to determine predictors of peak exercise HR. The model included gender, age, current exercise, ankle-brachial index, coronary artery disease, beta blockers, ACD, and atrial fibrillation (R = 44%, P = .01). Higher peak exercise HR was associated with older age, female gender, no beta blockers, and greater ACD ( P < .01). The findings from this descriptive study demonstrate the need for larger long-term studies to address issues of exercise adherence and the psychologic and functional benefits of exercise.
authors.affiliation: Department of Community Health Systems, School of Nursing, University of California at Los Angeles, 94143, USA.
authors.forename: Roberta K
authors.initials: RK
authors.lastname: Oka
authors.forename: Matt
authors.initials: M
authors.lastname: Altman
authors.forename: John C
authors.initials: JC
authors.lastname: Giacomini
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szuba
authors.forename: John P
authors.initials: JP
authors.lastname: Cooke
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002140:California; D015444:Exercise; D005080:Exercise Test; D005260:Female; D019538:Health Care Surveys; D006339:Heart Rate; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D008019:Life Style; D016014:Linear Models; D008297:Male; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010809:Physical Fitness; D011237:Predictive Value of Tests; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016138:Walking