title: Strength training increases walking tolerance in intermittent claudication patients: randomized trial.
abstract: OBJECTIVE
  To analyze the effects of strength training (ST) in walking capacity in patients with intermittent claudication (IC) compared with walking training (WT) effects.
  
  
  METHODS
  Thirty patients with IC were randomized into ST and WT. Both groups trained twice a week for 12 weeks at the same rate of perceived exertion. ST consisted of three sets of 10 repetitions of whole body exercises. WT consisted of 15 bouts of 2-minute walking. Before and after the training program walking capacity, peak VO(2), VO(2) at the first stage of treadmill test, ankle brachial index, ischemic window, and knee extension strength were measured.
  
  
  RESULTS
  ST improved initial claudication distance (358 +/- 224 vs 504 +/- 276 meters; P < .01), total walking distance (618 +/- 282 to 775 +/- 334 meters; P < .01), VO(2) at the first stage of treadmill test (9.7 +/- 2.6 vs 8.1 +/- 1.7 mL.kg(-1).minute; P < .01), ischemic window (0.81 +/- 1.16 vs 0.43 +/- 0.47 mm Hg minute meters(-1); P = .04), and knee extension strength (19 +/- 9 vs 21 +/- 8 kg and 21 +/- 9 vs 23 +/- 9; P < .01). Strength increases correlated with the increase in initial claudication distance (r = 0.64; P = .01) and with the decrease in VO(2) measured at the first stage of the treadmill test (r = -0.52; P = .04 and r = -0.55; P = .03). Adaptations following ST were similar to the ones observed after WT; however, patients reported lower pain during ST than WT (P < .01).
  
  
  CONCLUSIONS
  ST improves functional limitation similarly to WT but it produces lower pain, suggesting that this type of exercise could be useful and should be considered in patients with IC.
authors.affiliation: School of Physical Education, University of Pernambuco, Pernambuco, Brazil. raphael.dias@upe.br
authors.forename: Raphael Mendes
authors.initials: RM
authors.lastname: Ritti-Dias
authors.forename: Nelson
authors.initials: N
authors.lastname: Wolosker
authors.forename: Cláudia Lúcia
authors.initials: CL
authors.lastname: de Moraes Forjaz
authors.forename: Celso Ricardo Fernandes
authors.initials: CR
authors.lastname: Carvalho
authors.forename: Gabriel Grizzo
authors.initials: GG
authors.lastname: Cucato
authors.forename: Pedro Puech
authors.initials: PP
authors.lastname: Leão
authors.forename: Maria
authors.initials: M
authors.lastname: de Fátima Nunes Marucci
mesh_terms: D000368:Aged; D000842:Ankle / Q000098:blood supply; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D007511:Ischemia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D007717:Knee / Q000503:physiopathology; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010101:Oxygen Consumption; D010147:Pain Measurement; D020127:Recovery of Function; D055070:Resistance Training; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking