title: Cardiovascular training effect associated with polestriding exercise in patients with peripheral arterial disease.
abstract: Because individuals with claudication pain secondary to peripheral arterial disease (PAD) are limited in both walking speed and duration, the benefits of walking exercise may be insufficient to yield a cardiovascular training effect. The objectives of this analysis were to determine whether polestriding exercise training, performed by persons with PAD, would improve exercise endurance, elicit a cardiovascular training benefit, and improve quality of life (QoL). Persons (n = 49) whose claudication pain limited their exercise capacity were randomized into a 24-week polestriding training program (n = 25, 65.8 +/- 7.1 years of age) or a nonexercise attention control group (n = 24, 68.0 +/- 8.6 years of age). Those assigned to the polestriding group trained 3 times weekly. Control group subjects came to the laboratory biweekly for ankle blood pressure measurements. A symptom-limited ramp treadmill test, ratings of perceived leg pain, and QoL data (using the Short Form-36) were obtained at baseline and upon completion of training. After 24 weeks of polestriding training, subjects increased their exercise endurance from 10.3 +/- 4.1 minute to 15.1 +/- 4.5 minute. This was significantly greater than control group subjects whose exercise endurance declined (from 11.2 +/- 4.7 to 10.3 +/- 4.7 minute; P < .001). Relationships between systolic blood pressure (P < .001), heart rate (P = .04), rate pressure product (P = .05), oxygen uptake (P = .016), and perceived leg pain (P = .02) and exercise time improved from the baseline symptom-limited treadmill test to the 6-month symptom-limited treadmill test in the polestriding group compared to the control group. The improvement in the physical component summary score of the Short Form-36 was also greater in the polestriding group (P = .031). Polestriding training significantly improved the clinical indicators of cardiovascular fitness and QoL, and decreased symptoms of claudication pain during exertion.
authors.affiliation: Research and Development Service, Edward Hines Jr VA Hospital, Hines, IL 60141, USA. eileen.collins@med.va.gov
authors.forename: Eileen G
authors.initials: EG
authors.lastname: Collins
authors.forename: W Edwin
authors.initials: WE
authors.lastname: Langbein
authors.forename: Cynthia
authors.initials: C
authors.lastname: Orebaugh
authors.forename: Christine
authors.initials: C
authors.lastname: Bammert
authors.forename: Karla
authors.initials: K
authors.lastname: Hanson
authors.forename: Domenic
authors.initials: D
authors.lastname: Reda
authors.forename: Lonnie C
authors.initials: LC
authors.lastname: Edwards
authors.forename: Fred N
authors.initials: FN
authors.lastname: Littooy
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure; D016009:Chi-Square Distribution; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods* / Q000592:standards; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D008297:Male; D010101:Oxygen Consumption; D010147:Pain Measurement; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D010807:Physical Endurance; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D016138:Walking