title: Upper- versus lower-limb aerobic exercise training on health-related quality of life in patients with symptomatic peripheral arterial disease.
abstract: OBJECTIVE
  This randomized controlled trial investigated the effects of upper- and lower-limb aerobic exercise training on disease-specific functional status and generic health-related quality of life (QOL) in patients with intermittent claudication.
  
  
  METHODS
  The study recruited 104 patients (mean age, 68 years; range, 50-85) from the Sheffield Vascular Institute. Patients were randomly allocated to groups that received upper-limb (ULG) or lower-limb (LLG) aerobic exercise training, or to a nonexercise control group. Exercise was performed twice weekly for 24 weeks at equivalent limb-specific relative exercise intensities. Main outcome measures were scores on the Walking Impairment Questionnaire (WIQ) for disease-specific functional status, the Medical Outcomes Study Short Form version 2 (SF-36v2), and European Quality of Life Visual Analog Scale (EQ-VAS) for health-related QOL. Outcomes were assessed at baseline, and at 6, 24, 48, and 72 weeks.
  
  
  RESULTS
  After 6 weeks, improvements in the perceived severity of claudication (P = .023) and stair climbing ability (P = .011) vs controls were observed in the ULG, and an improvement in the general health domain of the SF-36v2 vs controls was observed in the LLG (P = .010). After 24 weeks, all four WIQ domains were improved in the ULG vs controls (P ≤ .05), and three of the four WIQ domains were improved in the LLG (P < .05). After 24 to 72 weeks of follow-up, more consistent changes in generic health-related QOL domains were apparent in the ULG.
  
  
  CONCLUSIONS
  These findings support the use of alternative, relatively pain-free forms of exercise in the clinical management of patients with intermittent claudication.
authors.affiliation: School of Allied Health Professions, University of East Anglia, Norwich, United Kingdom. john.saxton@uea.ac.uk
authors.forename: John M
authors.initials: JM
authors.lastname: Saxton
authors.forename: Irena
authors.initials: I
authors.lastname: Zwierska
authors.forename: Milisa
authors.initials: M
authors.lastname: Blagojevic
authors.forename: Sohail A
authors.initials: SA
authors.lastname: Choksy
authors.forename: Shah
authors.initials: S
authors.lastname: Nawaz
authors.forename: A Graham
authors.initials: AG
authors.lastname: Pockley
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004739:England; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D058729:Peripheral Arterial Disease / Q000150:complications / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D034941:Upper Extremity; D016138:Walking