Efficacy of arm-ergometry versus treadmill exercise training to improve walking distance in patients with claudication.
The efficacy of treadmill walking training to improve pain-free (PFWD) and maximal (MWD) walking distance in patients with claudication is well documented. The effects of aerobic arm-ergometry to improve PFWD and MWD compared to treadmill walking or usual care are not known. Forty-one participants (29 male, 12 female, mean age 67.7 years, 92.7% smoking history, 36.6% with diabetes) with lifestyle-limiting claudication were randomized to 12 weeks of 3 hours/week of supervised exercise training using either arm-ergometry, treadmill walking, or a combination, versus control. PFWD and MWD were assessed before and after training, and after 12 weeks of follow-up. The 12-week MWD increased significantly in the arm-ergometry (+53%), treadmill (+69%), and combination (+68%) groups (p < 0.002 versus control). The 24-week MWD was maintained in the arm-ergometry (p = 0.009) and treadmill (p = 0.019) groups, whereas the combination group declined (p = 0.751) versus control. The 12-week PFWD increased significantly in the arm-ergometry group (+82%; p = 0.025 versus control). Change in PFWD in treadmill (+54%; p = 0.196 versus control) and combination (+60%; p = 0.107 versus control) groups did not reach statistical significance. PFWD improvement was maintained in the arm-ergometry group after a 12-week follow-up (+123%; p = 0.011 versus control). In conclusion, these pilot data demonstrate for the first time that dynamic arm exercise training can improve walking capability in people with peripheral arterial disease (PAD)-induced claudication compared to participants receiving usual care and that improvement was not different from that seen with treadmill walking exercise training. Dynamic arm exercise may be a therapeutic exercise option for patients with PAD.
Treat-Jacobson
Diane
D
University of Minnesota School of Nursing, Center for Gerontological Nursing, Minneapolis, MN 55455, USA. treat001@umn.edu
Bronas
Ulf G
UG
Leon
Arthur S
AS
D000368:Aged; D000369:Aged, 80 and over; D016552:Ergometry; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010101:Oxygen Consumption; D010147:Pain Measurement; D010349:Patient Compliance; D016491:Peripheral Vascular Diseases / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity; D016138:Walking