Benefits of Low-Intensity Pain-Free Treadmill Exercise on Functional Capacity of Individuals Presenting with Intermittent Claudication Due to Peripheral Arterial Disease

Abstract

Patients with intermittent claudication due to peripheral arterial disease (PAD) experience muscle aching during walking secondary to ischemia. The purpose of this study was to examine the effects of low-intensity pain-free exercise (LIPFE) on functional capacity of individuals with PAD. A total of 12 participants with PAD underwent training on treadmill for 6 weeks, twice a week, for about 45 minutes. Outcome measures included walking distance (WDI), walking duration (WDU), mean walking rate (WR), estimated oxygen consumption (EVO2), metabolic equivalent (MET), estimated total energy expenditure (ETEE), and estimated rate of energy expenditure (EREE). Mean improvement of WDI, WDU, and MWR were 104% (an addition of 1.0 km), 55% (an addition of 13.3 minutes), and 41% (0.9 km/h faster), respectively. Mean improvement of EVO2, MET, ETEE, and EREE, were 20%, 20%, 80%, and 20%, respectively. In conclusion, it appears that LIPFE training is an effective intervention for individuals presenting with PAD.

Pain-free treadmill exercise for patients with intermittent claudication: Are there gender differences?

“…Therefore, the analysis was further restricted to only the participants that participated for 10-14 weeks, comparing performance based on gender using pooled data reported from previous studies. 3,[26][27][28][29][30] …”

“…3,[26][27][28][29][30] The protocol (see Figure 1) consists of having participants walk on a treadmill (Model 2000, Star Trac Treadmill, Unisen Inc, Tustin, CA) for 30 to 50 min two days per week, below the participant's minimal pain threshold (defined as a score of 0.5 to 1 on the IC Pain Scale, see Table 1). 3,[26][27][28][29][30] When participants felt IC pain, the speed of the treadmill was reduced by approximately 0.80 km with participants continuing to walk until the pain subsided. The patients would not stop unless they were at the minimum speed on the treadmill and a lower speed was not possible.…”

“…However, the authors in the present study posit that having patients walk to their maximal-pain threshold may deter them from adhering to exercise programs (a reduction in motivation due to discomfort associated with exercise), and this method may place patients as an increased risk for further medical complications. 3,[26][27][28][29][30] Given that women reportedly have a greater loss of mobility due to IC compared to men, this study focuses on investigating the effect of supervised pain-free treadmill exercise therapy on improving performance and reducing functional decline in women, in comparison to men, with IC due to PAD.…”

Impact of the Chronic Repetitive Leg Ischemia on Left Ventricular Function and Severity of Coronary Atherosclerosis in Patients with Acute Coronary Syndrome

“…Regular physical activity/walking is recommended in patients with PAD. It has been shown that regular exercise has an important beneficial impact on functional capacity and the prevention of PAD and CAD, particularly through the beneficial effects on endothelial function, antioxidant systems, heatshock protein expression, and vascular remodeling [12,13] . Supervised physical training, besides being the most effective means to increase walking ability, also proved to have a benefit on LV contractility.…”

Effect of Cilostazol Prescribed in a Pragmatic Treatment Program for Intermittent Claudication

“…An 8-week program with 3 exercise sessions per week features a pain-free, symptom-responsive, low intensity treadmill protocol. 20 This effort includes additional objective and quality-of-life evaluations that are lacking in this current retrospective report. Specifically, objective measures such as maximal walking distance, walking duration, mean walking rate, estimated oxygen consumption, metabolic equivalents, estimated total energy expenditure, and estimated rate of energy expenditure are incorporated at intervals throughout the program.…”