title: Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication.
abstract: BACKGROUND
  In this randomized trial we compared two treadmill trainings, based on exercises performed to moderate claudication pain vs pain-free training, with respect to their effects on walking ability and endothelial function.
  
  
  METHODS
  A total of sixty patients with stable intermittent claudication were randomized to the pain-free treadmill training (repetitive intervals to onset of claudication pain) or moderate treadmill training (repetitive intervals to moderate claudication pain). In both groups exercises were performed 3 times a week for 3 months. Changes in flow mediated dilatation (FMD) and treadmill walking performance as well as plasma levels of C-reactive protein (hs-CRP) and fibrinogen were assessed before and after the program.
  
  
  RESULTS
  Fifty-two patients completed the training program. Post-training maximal walking time was prolonged by 100% (p<0.001) vs 98% (p<0.001), and pain-free walking time by 120% (p<0.001) vs 93% (p<0.001) in the moderate training group as compared to the pain-free training group, respectively. FMD increased by 56% (p<0.001) in the moderate training group and by 36% (p<0.01) in the pain-free training group. No significant changes in the levels of hs-CRP and fibrinogen were seen after treadmill program in either group.
  
  
  CONCLUSIONS
  Both pain-free treadmill training and the moderate treadmill training have similar efficacy on walking ability in patients with claudication. The improvement of post-training FMD indicates systemic effect of both treadmill programs on endothelial function. Both programs appear to be safe therapeutic modes, since none of them escalates the inflammation. Pain-free treadmill training seems useful and effective therapeutic option for patients with claudication.
authors.affiliation: Department of Clinical Rehabilitation, University School of Physical Education, Cracow, Poland. Electronic address: piotrmika@poczta.fm.
authors.forename: Piotr
authors.initials: P
authors.lastname: Mika
authors.forename: Anita
authors.initials: A
authors.lastname: Konik
authors.forename: Rafal
authors.initials: R
authors.lastname: Januszek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Petriczek
authors.forename: Anna
authors.initials: A
authors.lastname: Mika
authors.forename: Roman
authors.initials: R
authors.lastname: Nowobilski
authors.forename: Rafal
authors.initials: R
authors.lastname: Nizankowski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szczeklik
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D004730:Endothelium, Vascular / Q000502:physiology*; D005080:Exercise Test / Q000379:methods*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014664:Vasodilation / Q000502:physiology*; D016138:Walking / Q000502:physiology*
keywords: Atherosclerosis; Claudication; Endothelial function; Treadmill training