title: Changes in Function After a 6-Month Walking Intervention in Patients With Intermittent Claudication Who Are Obese or Nonobese.
abstract: OBJECTIVE
  Both obesity and peripheral artery disease (PAD) limit function and may work additively to reduce mobility. The purpose of this study was to compare the effects of a 6-month, center-based walking program on mobility function between adults who are weight-stable obese and nonobese with PAD.
  
  
  METHODS
  This is a secondary data analysis of 2 combined studies taken from previous work. Fifty-three adults with PAD and intermittent claudication participated in 6 months of treadmill training or standard of care. Patients were divided into 4 groups for analyses: exercise nonobese (Ex), exercise obese (ExO), standard-of-care nonobese (SC), and standard-of-care obese (SCO). Mobility was assessed by a standardized treadmill test to measure claudication onset time (COT) and peak walking time (PWT) as well as the distance walked during a 6-minute walk distance (6MWD) test.
  
  
  RESULTS
  There was a significant (P < .001) interaction (intervention × obesity) effect on 6MWD, wherein both exercise groups improved (Ex = 7%, ExO = 16%; P < .02), the SC group did not change (0.9%; P > .05), and the SCO group tended to decline (-18%; P = .06). Both exercise intervention groups significantly improved COT (Ex = 92%, ExO = 102%; P < .01) and PWT (Ex = 54%, ExO = 103%; P < .001). There was no change (P > .05) in either standard-of-care group.
  
  
  CONCLUSIONS
  Individuals who are obese and nonobese with PAD made similar improvements after a 6-month, center-based walking program. However, patients who are obese with PAD and do not exercise may be susceptible to greater declines in mobility. Exercise may be particularly important in patients who are obese with PAD to avoid declines in mobility.
authors.affiliation: 1Department of Medicine, Division of Gerontology, University of Maryland, Baltimore. 2Department of Veterans Affairs and Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Centers, Baltimore, Maryland. 3Department of Surgery, Division of Vascular Surgery, University of Maryland, Baltimore. 4Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center, Oklahoma City.
authors.forename: Odessa
authors.initials: O
authors.lastname: Addison
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ryan
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Prior
authors.forename: Leslie I
authors.initials: LI
authors.lastname: Katzel
authors.forename: Rishi
authors.initials: R
authors.lastname: Kundi
authors.forename: Brajesh K
authors.initials: BK
authors.lastname: Lal
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Gardner
mesh_terms: D000328:Adult; D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009765:Obesity / Q000453:epidemiology* / Q000534:rehabilitation*; D016896:Treatment Outcome; D016138:Walking