Training rather than walking: the test in -train out program for home-based rehabilitation in peripheral arteriopathy.
BACKGROUND
Exercise training reduces walking disability in peripheral arterial disease (PAD). This non-randomized study evaluates the effects on walking ability and hemodynamic parameters of a novel approach to home-based rehabilitation, the test in -train out program (Ti-To), compared with the traditional home-based free walking exercise (Tr-E).


RESULTS
A total of 143 patients with claudication (117 men, average age 68+/-10 years), were included in a Ti-To (n=83) or Tr-E program (n=60). Evaluations, which were carried out upon entry and at 1, 2, 3, 4 and 6 months, included: self-reported claudication, walking ability (ie, absolute claudication distance, pain threshold speed), resting/exercise heart rates (HR), systolic/diastolic brachial pressure (SBP/DBP), ankle pressure (AP), ankle-brachial index (ABI). Ti-To involved 2 daily 10-min home walking sessions at maximal asymptomatic speed and the patient attending monthly check-ups at hospital. Tr-E involved 20-30 min of daily walking at self-selected speeds up to pain tolerance. A total of 126 patients (Ti-To, n=74; Tr-E, n=52) completed the program. Ti-To induced better relief from claudication (p=0.001). Functional parameters improved significantly for both groups (p<0.0001) with significant intergroup difference for Ti-To (p<0.0001). SBP and exercise HR decreased significantly in both groups, with Ti-To improving resting HR (p=0.0002), DBP (p=0.003), lowest AP worse limb (p=0.004) and ABI worse limb (p=0.0002).


CONCLUSIONS
In patients with PAD, a Ti-To program had more positive effects on perceived claudication, and functional and hemodynamic parameters than did a Tr-E program.
Manfredini
Fabio
F
Center of Biomedical Studies Applied to Sport, University of Ferrara, Ferrara, Italy. mdf@unife.it
Malagoni
Anna Maria
AM
Mascoli
Francesco
F
Mandini
Simona
S
Taddia
Maria Cristina
MC
Basaglia
Nino
N
Manfredini
Roberto
R
Conconi
Francesco
F
Zamboni
Paolo
P
D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging; D001794:Blood Pressure; D001916:Brachial Artery / Q000000981:diagnostic imaging; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006339:Heart Rate; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D010809:Physical Fitness; D012039:Regional Blood Flow; D016896:Treatment Outcome; D014463:Ultrasonography; D016138:Walking