title: Preprogrammed oscillations improve lower limb blood flow and walking distance in patients with peripheral arterial disease.
abstract: BACKGROUND
  Claudication is one of the sequelae of peripheral arterial disease (PAD). To date, no effective treatment has been found for this condition.
  
  
  OBJECTIVE
  To investigate a new device to treat PAD. The device administers pre-programmed protocols of oscillations to the foot.
  
  
  METHODS
  Fifteen patients aged 40-70 years who suffered from intermittent claudication secondary to PAD were recruited to an open prospective study. Each patient was treated once for 30 minutes. The following parameters were evaluated: pain-free and maximal walking distances, skin blood flux by laser-Doppler, skin temperature, ankle-brachial and toe-brachial indices, transcutaneous oxygen pressure (tcpO2) and transcutaneous carbon dioxide pressure (tcpCO2). Non-parametric signed-rank test was applied for testing differences between baseline assessment and post-treatment assessments for quantitative parameters.
  
  
  RESULTS
  Mean pain-free walking distance was 122 +/- 33 m and increased to 277 +/- 67 m, after the treatment session (P = 0.004). Mean maximal walking distance was 213 +/- 37 m and it increased to 603 +/- 77 m (P < 0.001). Foot skin perfusion also improved, as demonstrated by an increase in tcpO2 by 28.6 +/- 4.1 mmHg (P < 0.001), a decrease in tcpCO2 by 2.8 +/- 1.3 (P= 0.032), and up to twofold improvement in blood flux parameters, and an increase in skin temperature by 1.9 +/- 0.5 degrees C (P < 0.001). Ankle-brachial index increased by 0.06 +/- 0.01 (P = 0.003) and toe-brachial index by 0.17 +/- 0.02 (P < 0.001).
  
  
  CONCLUSIONS
  Preprogrammed oscillations applied to the foot had a positive effect on microcirculation, tissue oxygenation and CO2 clearance; they had a smaller though significant effect on arterial blood pressure indices, and the change in the arterial-brachial index correlated with the change in the pain-free walking distance.
authors.forename: Igor
authors.initials: I
authors.lastname: Rabin
authors.forename: Uri
authors.initials: U
authors.lastname: Shpolanski
authors.forename: Allon
authors.initials: A
authors.lastname: Leibovitz
authors.forename: Arie
authors.initials: A
authors.lastname: Bass
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001785:Blood Gas Monitoring, Transcutaneous; D001794:Blood Pressure / Q000502:physiology; D004867:Equipment Design; D005260:Female; D005528:Foot / Q000098:blood supply*; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010147:Pain Measurement; D058729:Peripheral Arterial Disease / Q000503:physiopathology / Q000628:therapy*; D011312:Pressure; D012039:Regional Blood Flow / Q000502:physiology; D012881:Skin Temperature / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
chemical_list: D010100:Oxygen