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PURPOSE The purpose of this study was to compare the effects of a 24-week walking with poles rehabilitation program with a traditional 24-week walking program on physical function in patients with peripheral arterial disease (PAD). METHODS Patients with PAD (n=103, age = 69.7±8.9 years, ankle-brachial index <0.90 or evidence of calcified vessels) were randomized into a rehabilitation program of traditional walking (n=52) or walking with poles (n=51). Patients exercised 3 times per week for 24 weeks. Exercise endurance was measured by time walked on a constant workrate treadmill test at 6, 12, and 24 weeks. Perceived physical function was measured by the SF-36 and Walking Impairment Questionnaire. Tissue oxygenation was measured using near-infrared spectroscopy. RESULTS Patients assigned to the traditional walking group walked longer at 24 weeks than those assigned to the pole walking group (21.10±17.07 min and 15.02±12.32 respectively, P=.037). There were no differences between the groups in tissue oxygenation. However, there was a significant lengthening of time for which it took to reach minimum tissue oxygenation values (P <0.001) within the groups on the constant workrate test. There were no differences between the groups in perceived physical function as measured by the physical function subscale on the Short-Form 36 or perceived walking distance as measured by the walking distance subscale on the Walking Impairment Scale. CONCLUSIONS Traditional walking was superior to walking with poles in increasing walking endurance on a constant workrate treadmill test for patients with peripheral arterial disease.

A BS TRACT: Background: Sleep dysfunction is common and disabling in persons with Parkinson's Disease (PD). Exercise improves motor symptoms and subjective sleep quality in PD, but there are no published studies evaluating the impact of exercise on objective sleep outcomes. The goal of this study was to to determine if high-intensity exercise rehabilitation combining resistance training and bodyweight interval training, compared with a sleep hygiene control improved objective sleep outcomes in PD. Methods: Persons with PD (Hoehn & Yahr stages 2-3; aged ≥45 years, not in a regular exercise program) were randomized to exercise (supervised 3 times a week for 16 weeks; n = 27) or a sleep hygiene, no-exercise control (in-person discussion and monthly phone calls; n = 28). Participants underwent polysomnography at baseline and post-intervention. Change in sleep efficiency was the primary outcome, measured from baseline to postintervention. Intervention effects were evaluated with general linear models with measurement of group × time interaction. As secondary outcomes, we evaluated changes in other aspects of sleep architecture and compared the effects of acute and chronic training on objective sleep outcomes. Results: The exercise group showed significant improvement in sleep efficiency compared with the sleep hygiene group (group × time interaction: F = 16.0, P < 0.001, d = 1.08). Other parameters of sleep architecture also improved in exercise compared with sleep hygiene, including total sleep time, wake after sleep onset, and slow-wave sleep. Chronic but not acute exercise improved sleep efficiency compared with baseline. Conclusions: High-intensity exercise rehabilitation improves objective sleep outcomes in PD. Exercise is an effective nonpharmacological intervention to improve this disabling nonmotor symptom in PD.