Effects of a long-term exercise program on lower limb mobility, physiological responses, walking performance, and physical activity levels in patients with peripheral arterial disease.
OBJECTIVE
The purpose of the study was to examine the effects of a 12-month exercise program on lower limb mobility (temporal-spatial gait parameters and gait kinematics), walking performance, peak physiological responses, and physical activity levels in individuals with symptoms of intermittent claudication due to peripheral arterial disease (PAD-IC).


METHODS
Participants (n = 21) with an appropriate history of PAD-IC, ankle-brachial pressure index (ABI) <0.9 in at least one leg and a positive Edinburgh claudication questionnaire response were prospectively recruited. Participants were randomly allocated to either a control PAD-IC group (CPAD-IC) (n = 11) that received standard medical therapy and a treatment PAD-IC group (TPAD-IC) (n = 10), which also took part in a 12-month supervised exercise program. A further group of participants (n = 11) free of PAD (ABI >0.9) and who were non-regular exercisers were recruited from the community to act as age and mass matched controls (CON). Lower limb mobility was determined via two-dimensional video motion analysis. A graded treadmill test was used to assess walking performance and peak physiological responses to exercise. Physical activity levels were measured via a 7-day pedometer recording. Differences between groups were analyzed via repeated measures analysis of variance (ANOVA).


RESULTS
The 12-month supervised exercise program had no significant effect on lower limb mobility, peak physiological responses, or physical activity levels in TPAD-IC compared with CPAD-IC participants. However, the TPAD-IC participants demonstrated significantly greater walking performance (171% improvement in pain free walking time and 120% improvement in maximal walking time compared with baseline).


CONCLUSIONS
The results of this study confirm that a 12-month supervised exercise program will result in improved walking performance, but does not have an impact on lower limb mobility, peak physiological responses, or physical activity levels of PAD-IC patients.
Crowther
Robert G
RG
Institute of Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia. Robert.Crowther@jcu.edu.au <Robert.Crowther@jcu.edu.au>
Spinks
Warwick L
WL
Leicht
Anthony S
AS
Sangla
Kunwarjit
K
Quigley
Frank
F
Golledge
Jonathan
J
D000368:Aged; D000842:Ankle / Q000098:blood supply; D001696:Biomechanical Phenomena; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D004311:Double-Blind Method; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005684:Gait; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording; D016138:Walking