title: Relative tolerance to upper- and lower-limb aerobic exercise in patients with peripheral arterial disease.
abstract: OBJECTIVE
  To investigate the effects of peripheral arterial disease (PAD) on relative tolerance to upper- and lower-limb aerobic exercise.
  
  
  METHODS
  Peak cardiorespiratory responses evoked by an incremental arm-cranking test (ACT) and an incremental leg-cranking test (LCT) were compared in patients with PAD (N=101; median age 69 year, range 50-85 years). Claudication distance (CD) and total distance before intolerable claudication pain (maximum walking distance: MWD) were also assessed during walking.
  
  
  RESULTS
  Peak oxygen consumption (V O(2)) for the ACT was 94% of that measured for the LCT (1.01+/-0.03 versus 1.10+/-0.03lmin(-1), respectively; P<0.001), but in a significant proportion of patients (35%; P<0.001), exceeded that recorded for the LCT. The ratio of upper- to lower-limb peak V O(2) was higher (0.98+/-0.04 compared to 0.98+/-0.05lmin(-1) and 1.00+/-0.06 compared to 1.21+/-0.06lmin(-1); P<0.01), whereas walking performance (CD: 94+/-14 versus 187+/-25 m, P<0.01; MWD: 227+/-20 versus 394+/-33 m, P<0.01) was lower for patients in the lowest ankle to brachial pressure index quartile compared to patients in the highest quartile, respectively.
  
  
  CONCLUSIONS
  Upper-limb aerobic conditioning could be a useful exercise stimulus for maintaining or improving cardiorespiratory function in patients with severe PAD as they have a greater relative upper-limb aerobic power.
authors.affiliation: The Centre for Sport and Exercise Science, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield S10 2BP, UK.
authors.forename: I
authors.initials: I
authors.lastname: Zwierska
authors.forename: R D
authors.initials: RD
authors.lastname: Walker
authors.forename: S A
authors.initials: SA
authors.lastname: Choksy
authors.forename: J S
authors.initials: JS
authors.lastname: Male
authors.forename: A G
authors.initials: AG
authors.lastname: Pockley
authors.forename: J M
authors.initials: JM
authors.lastname: Saxton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005121:Extremities; D005260:Female; D006339:Heart Rate; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology*; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D011659:Pulmonary Gas Exchange; D012123:Pulmonary Ventilation; D016138:Walking
chemical_list: D019344:Lactic Acid