title: 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.
abstract: 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.
authors.affiliation: Institute of Sport and Exercise Science, James Cook University, Townsville, Queensland, Australia. Robert.Crowther@jcu.edu.au <Robert.Crowther@jcu.edu.au>
authors.forename: Robert G
authors.initials: RG
authors.lastname: Crowther
authors.forename: Warwick L
authors.initials: WL
authors.lastname: Spinks
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Leicht
authors.forename: Kunwarjit
authors.initials: K
authors.lastname: Sangla
authors.forename: Frank
authors.initials: F
authors.lastname: Quigley
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
mesh_terms: 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