A comparative study of treadmill tests and heel raising exercise for peripheral arterial disease

Amirhamzeh, Mehrdad M.R.; Chant, Harvey; Rees, Jonathan; Hands, L; Powell, Roy; Campbell, William B.

doi:10.1016/s1078-5884(97)80102-5

Cited by 45 publications

(40 citation statements)

References 5 publications

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“…Potential participants with an ABI >0.90 are also eligible, if a certified vascular laboratory demonstrated prior lower extremity ischemia. Participants with prior lower extremity revascularization are eligible only if they have a 20% drop in ABI following a heel-rise test (27). Based on our experience in prior clinical trials of participants with PAD, fewer than five percent of all participants will be included because they have an ABI > 0.90 at baseline and meet one of these criteria (28).…”

Section: Methodsmentioning

confidence: 99%

Progenitor cell release plus exercise to improve functional performance in peripheral artery disease: The PROPEL Study

Domanchuk

Ferrucci

Guralnik

et al. 2013

Contemporary Clinical Trials

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Functional impairment, functional decline, and mobility loss are major public health problems in people with lower extremity peripheral artery disease (PAD). Few medical therapies significantly improve walking performance in PAD. We describe methods for the PROgenitor cell release Plus Exercise to improve functionaL performance in PAD (PROPEL) Study, a randomized controlled clinical trial designed to determine whether granulocyte-macrophage colony stimulating factor (GM-CSF) combined with supervised treadmill walking exercise improves six-minute walk distance more than GM-CSF alone, more than supervised treadmill exercise alone, and more than placebo plus attention control in participants with PAD, respectively. PROPEL Study participants are randomized to one of four arms in a 2 by 2 factorial design. The four study arms are GM-CSF plus supervised treadmill exercise, GM-CSF plus attention control, placebo plus supervised exercise therapy, or placebo plus attention control. The primary outcome is change in six-minute walk distance at 12-week follow-up. Secondary outcomes include change in brachial artery flow-mediated dilation (FMD), change in maximal treadmill walking time, and change in circulating CD34+ cells at 12-week follow-up. Outcomes are also measured at six-week and six-month follow-up. Results of the PROPEL Study will have important implications for understanding mechanisms of improving walking performance and preventing mobility loss in the large and growing number of men and women with PAD.

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Section: Methodsmentioning

confidence: 99%

Progenitor cell release plus exercise to improve functional performance in peripheral artery disease: The PROPEL Study

Domanchuk

Ferrucci

Guralnik

et al. 2013

Contemporary Clinical Trials

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

“…Potential participants with a resting ABI ≥ 0.91 and ≤ 1.00 at baseline are eligible if their ABI drops by at least 20% following a heel-rise test (18,19). Prior study shows that an ABI decline > 20% after the heel-rise test is highly correlated with ABI declines after a treadmill exercise stress test (18,19). Potential participants with a resting ABI greater than 0.90 are also potentially eligible if they provide data from a certified vascular laboratory demonstrating prior lower extremity ischemia or if they have medical record documented evidence of prior lower extremity revascularization.…”

Section: Methodsmentioning

confidence: 99%

The Group Oriented Arterial Leg Study (GOALS) to improve walking performance in patients with peripheral arterial disease

McDermott

Domanchuk

Liu

et al. 2012

Contemporary Clinical Trials

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People with lower extremity peripheral artery disease (PAD) have greater functional impairment and faster functional decline than those without PAD. We describe methods for the Group Oriented Arterial Leg Study (GOALS), an ongoing randomized controlled clinical trial designed to determine whether a Group-Mediated Cognitive Behavioral (GMCB) intervention improves functional performance in PAD participants, compared to a health education control condition. In GOALS, PAD participants are randomized to either an intervention or a health education control condition in a parallel design. Both conditions consist of weekly group sessions with other PAD participants. In the intervention, cognitive behavioral techniques are used to assist participants in setting and adhering to home-based walking exercise goals. Participants are encouraged to walk for exercise at home at least five days per week. In the control condition, participants receive lectures on health-related topics. After six months of on-site weekly sessions, participants are transitioned to telephone follow-up for another six months. Participants in the intervention are asked to continue home walking exercise. The primary outcome is change in six-minute walk performance between baseline and six-month follow-up. Secondary outcomes include change in six-minute walk performance at 12-month follow-up, and change in treadmill walking performance, the Walking Impairment Questionnaire, quality of life, and physical activity at six and 12-month follow-up. In conclusion, if our group-mediated cognitive behavioral intervention is associated with improved walking performance in individuals with PAD, results will have major public health implications for the large and growing number of people with PAD.

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“…Thus the Naughton protocol may represent a more precise and reproducible exercise test, and previous studies have shown that the Naughton test appears to be a more sensitive measure in detecting changes in exercise capacity compared with the 6-min walking test in less sick patients with PH [36]. However, some elderly patients find treadmill assessments stressful or perform poorly due to restricting factors in more severe cardiovascular co-morbidities [37]. The use of the Naughton test can be problematic, as the test is terminated when the patient is unable to maintain the imposed workload.…”

Section: Figure 2 Distribution Of Urinary Et-1 At Baseline and Duringmentioning

confidence: 99%

Effects of pravastatin on functional capacity in patients with chronic obstructive pulmonary disease and pulmonary hypertension

et al. 2009

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PH (pulmonary hypertension) often complicates the disease course of patients with COPD (chronic obstructive pulmonary disease) and is an indication of a worse prognosis. In the present study, we assessed whether pravastatin administration was effective in improving PH and exercise capacity in COPD patients with PH, and whether the pulmonary protection was mediated by inhibiting ET-1 (endothelin-1) production. In a double-blind parallel design, 53 COPD patients with PH were randomly assigned to receive either placebo or pravastatin (40 mg/day) over a period of 6 months at a medical centre. Baseline characteristics were similar in both groups. The exercise time remained stable throughout the study in the placebo group. After 6 months, the exercise time significantly increased 52% from 660+/-352 to 1006+/-316 s (P<0.0001) in pravastatin-treated patients. With pravastatin, echocardiographically derived systolic PAP (pulmonary artery pressure) decreased significantly from 47+/-8 to 40+/-6 mmHg. There was significant improvement in the Borg dyspnoea score after administering pravastatin. Despite unchanged plasma ET-1 levels throughout the study, urinary excretion of the peptide was decreased and significantly correlated with an improvement in exercise time in pravastatin-treated patients (r=-0.47, P=0.01). In conclusion, pravastatin significantly improved exercise tolerance, and decreased PH and dyspnoea during exercise in COPD patients with PH, probably by inhibiting ET-1 synthesis.

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A comparative study of treadmill tests and heel raising exercise for peripheral arterial disease

Abstract: Heel raising produced changes in ankle pressure which correlated well with those induced by treadmill exercise. We recommend the use of simple heel raising when a stress test is required to diagnose lower limb arterial insufficiency in the outpatient clinic.

Cited by 45 publications

References 5 publications

Progenitor cell release plus exercise to improve functional performance in peripheral artery disease: The PROPEL Study

Progenitor cell release plus exercise to improve functional performance in peripheral artery disease: The PROPEL Study

The Group Oriented Arterial Leg Study (GOALS) to improve walking performance in patients with peripheral arterial disease

Effects of pravastatin on functional capacity in patients with chronic obstructive pulmonary disease and pulmonary hypertension

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