title: Peripheral arterial disease and intermittent claudication: efficacy of short-term upper body strength training, dynamic exercise training, and advice to exercise at home.
abstract: OBJECTIVE
  To compare the effect of two training programmes and advice to exercise at home on physiological adaptations in patients with peripheral arterial disease (PAD).
  
  
  METHODS
  30 patients with a typical history of PAD and intermittent claudication were randomised to either an upper body strength training programme (UBST), a dynamic (walking, cycling, circuit) conventional exercise rehabilitation programme (CER), or advice to 'walk as much as possible at home' (CONT). Before and after intervention groups performed a standard graded treadmill exercise test (GTET) and a 6-minute walk test (SMWT) to determine peak physiological parameters and walking distances. Maximal walking distance (MWD), pain-free walking distance (PFWD), peak oxygen uptake (VO2) , heart rate and perceived pain were measured.
  
  
  RESULTS
  MWD on the GTET increased significantly in the CER group compared with the CONT and UBST groups (93.9 +/- 79% v. 7.0 +/- 19.8% v. 7.3 +/- 46%; CER v. UBST v. CONT p = 0.003). Similarly, peak VO2 increased with CER compared with the CONT and UBST groups (28.4 +/- 20 v. -6.2 +/- 15 v. -1.0 +/- 21%; CER v. UBST v. CONT p = 0.004). During the SMWT the CER and UBST groups improved in PFWD compared with the CONT group (37 +/- 47% v. 27 +/- 71% v. -30 +/- 29%; CER v. UBST v. CONT p = 0.03), and perceived pain decreased in the CER group compared with the UBST group (-24 +/- 39% v. 27 +/- 48%; CER v. UBST p = 0.01).
  
  
  CONCLUSIONS
  CER improves physiological parameters and walking distances more than UBST does. CER is effective within 6 weeks. Verbal encouragement to exercise is an ineffective form of management.
authors.affiliation: Cape Peninsula University of Technology, Cape Town. parrb@cput.ac.za
authors.forename: B M
authors.initials: BM
authors.lastname: Parr
authors.forename: T D
authors.initials: TD
authors.lastname: Noakes
authors.forename: E W
authors.initials: EW
authors.lastname: Derman
mesh_terms: D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006339:Heart Rate; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010353:Patient Education as Topic; D016491:Peripheral Vascular Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D055070:Resistance Training; D012648:Self Care