title: Effect of exercise training on clot strength in patients with peripheral artery disease and intermittent claudication: An ancillary study.
abstract: OBJECTIVE
  Patients with peripheral artery disease have walking impairment, greater thrombotic risk, and are often treated with exercise training. We sought to determine the effect of a 3-month-long exercise program on clot strength among patients with peripheral artery disease and intermittent claudication.
  
  
  METHODS
  Twenty-three symptomatic peripheral artery disease patients were randomly assigned to a walking exercise program or to an attention control group who performed light resistance exercise. We investigated the effect of exercise training on clot strength and time to clot formation was assessed by thromboelastography.
  
  
  RESULTS
  After 3 months of exercise, clot strength (maximal amplitude) and time to clot formation (R) did not change significantly from baseline, even after improvements in claudication onset time (p < 0.01) and peak walking time (p < 0.05). Furthermore, changes in clot formation parameters were not significantly different between groups. Among the 10 individuals demonstrating a reduction in clot strength (reduced maximal amplitude), one was a smoker (10%) compared to 9 of 13 non-responders (69%) whose maximal amplitude was unchanged or increased (p = 0.0097).
  
  
  CONCLUSIONS
  In this ancillary study, a 12-week walking program improved ambulatory function in peripheral artery disease patients with claudication, but does not modify clot strength or time to clot formation. Larger studies are needed to confirm these hypothesis generating findings and to determine whether a different amount or type of exercise may induce a change in clotting in this patient population.
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
authors.forename: Karin
authors.initials: K
authors.lastname: Mauer
authors.affiliation: Department of Cardiology, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
authors.forename: J Emilio
authors.initials: JE
authors.lastname: Exaire
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.affiliation: Department of Cardiology, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: Jorge F
authors.initials: JF
authors.lastname: Saucedo
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
authors.forename: Polly S
authors.initials: PS
authors.lastname: Montgomery
authors.affiliation: Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA; Veterans Affairs Medical Center, Oklahoma City, OK, USA.
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Gardner
keywords: Peripheral artery disease; clot strength; exercise training