Cardiopulmonary responses to treadmill and cycle ergometry exercise in patients with peripheral vascular disease

Tuner, Stephen L.; Easton, Chris; Wilson, John; Byrne, Dominique; Rogers, Paul C.; Kilduff, Liam P.; Kingsmore, David; Pitsiladis, Yannis

doi:10.1016/j.jvs.2007.09.001

Cited by 33 publications

(18 citation statements)

References 26 publications

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“…Generally, healthy controls have ICCs in the range of 0.85 to 0.98 for VO 2 peak and maximal heart rate (4,20,21). Turner et al (22) reported high correlations for peak heart rate (r=0.94) and peak oxygen uptake (r=0.98) in subjects with peripheral arterial disease and claudication. Riebe (16) also reported high intraclass correlations for peak oxygen consumption (r = 0.97) in patients with peripheral arterial disease.…”

Section: Discussionmentioning

confidence: 99%

Repeatability of Aerobic Capacity Measurements in Parkinson Disease

Katzel¹,

Sorkin

Macko³

et al. 2011

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Maximal or peak aerobic capacity (VO2peak) during a maximal effort graded exercise test (GXT) is considered by many to be the “gold standard” outcome for assessing the impact of exercise training on cardiorespiratory fitness. The reliability of this measure in Parkinson Disease (PD) has not been established, where the degree of motor impairment can vary greatly and is influenced by medications. This study examined the reliability of VO2peak during maximal effort GXT in subjects with PD. Methods Seventy healthy middle-aged and older subjects with PD, Hoehn and Yahr stage 1.5 to 3 underwent a screening/acclimatization maximal effort treadmill test followed by 2 additional maximal effort treadmill tests with repeated measurements of VO2peak. A third VO2peak test was performed in a subset of 21 subjects. Results The mean VO2peak measurement was 2.4% higher in the second test compared to the first test (21.42 ± 4.3 ml/kg/min versus 21.93 ± 4.50 ml/kg/min, mean ± SD, p=0.03). The intraclass correlation coefficients (ICC) for VO2peak expressed either as ml/kg/min or L/min was highly reliable, with ICC of 0.90 and 0.94 respectively. The maximum heart rate (ICC of 0.91), and final speed achieved during the tests (ICC of 0.94) were also highly reliable, with the respiratory quotient (RQ) being the least reliable of the parameters measured (ICC of 0.65). Conclusion Our results demonstrate that measurement of VO2peak is reliable and repeatable in subjects with mild to moderate PD, thereby validating use of this parameter for assessing the effects of exercise interventions on cardiorespiratory fitness.

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Section: Discussionmentioning

confidence: 99%

Repeatability of Aerobic Capacity Measurements in Parkinson Disease

Katzel¹,

Sorkin

Macko³

et al. 2011

Medicine &Amp; Science in Sports &Amp; Exercise

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“…There has been the suggestion to evaluate PAD patients using a cycle ergometer to avoid the gait problems during treadmill walking. However, the outcome of limited performance and pain onset was similar to that achieved during walking, although a higher cardiopulmonary response could be elicited (940). Treatment of PAD patients with pentoxifylline or cilostazol, which improves exercise tolerance, does not improve gait abnormalities (429, 430).…”

Section: Training Improves Walking Efficiency In Pad Patients Durimentioning

confidence: 93%

Exercise Training and Peripheral Arterial Disease

Haas

Lloyd

Yang

et al. 2012

Comprehensive Physiology

121

108

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Peripheral arterial disease (PAD) is a common vascular disease that reduces blood flow capacity to the legs of patients. PAD leads to exercise intolerance that can progress in severity to greatly limit mobility, and in advanced cases leads to frank ischemia with pain at rest. It is estimated that 12–15 million people in the United States are diagnosed with PAD, with a much larger population that is undiagnosed. The presence of PAD predicts a 50–1500% increase in morbidity and mortality, depending on severity. Treatment of patients with PAD is limited to modification of cardiovascular disease risk factors, pharmacological intervention, surgery, and exercise therapy. Extended exercise programs that involve walking ~5 times/wk, at a significant intensity that requires frequent rest periods, are most significant. Pre-clinical studies and virtually all clinical trials demonstrate the benefits of exercise therapy, including: improved walking tolerance, modified inflammatory/hemostatic markers, enhanced vasoresponsiveness, adaptations within the limb (angiogenesis, arteriogenesis, mitochondrial synthesis) that enhance oxygen delivery and metabolic responses, potentially delayed progression of the disease, enhanced quality of life indices, and extended longevity. A synthesis is provided as to how these adaptations can develop in the context of our current state of knowledge and events known to be orchestrated by exercise. The benefits are so compelling that exercise prescription should be an essential option presented to patients with PAD in the absence of contraindications. Obviously, selecting for a life style pattern, that includes enhanced physical activity prior to the advance of PAD limitations, is the most desirable and beneficial.

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“…A number of studies have demonstrated leg ergometry to be an effective approach for improving walking and/or cycling outcomes for PAD patients [34–37]. Additionally, Tuner et al [38] evaluated absolute claudication time and cardiorespiratory outcomes during incremental cycling and treadmill exercise testing in a group of PAD patients with IC. Results indicated similar absolute claudication time outcomes between the two modalities in addition to significantly higher cardiovascular and metabolic responses during leg ergometry compared to treadmill walking.…”

Section: Exercise Therapy For Claudicationmentioning

confidence: 99%

“…able to induce IC thus providing specific training to affected lower limbs in addition to central cardiovascular adaptations [38]…”

Section: Tablementioning

confidence: 99%

Exercise Therapy for Claudication: Latest Advances

Mays

Regensteiner

2013

Curr Treat Options Cardio Med

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Opinion statement Peripheral artery disease (PAD) creates a significant national and international healthcare burden. A first line treatment for PAD is supervised walking exercise in hospitals and clinics. Specifically, supervised walking exercise seeks to improve the classic symptom associated with PAD, intermittent claudication (IC), which is characterized by cramping, aching and pain of the muscles in the lower extremities during walking. While effective, supervised walking exercise is often not prescribed or utilized due to a number of treatment barriers such as lack of transportation to clinical centers and lack of insurance reimbursement. Walking exercise in community settings is an option that has gained attention due to the limitations of supervised walking exercise, as community walking is generally more convenient in terms of a patient’s schedule and may circumvent potential barriers such as treatment cost and transportation difficulties. However, more research is needed to improve the effectiveness of community-based walking programs since far less is known about the optimal structure of such programs. Other exercise therapy options are becoming available for PAD patients in addition to walking exercise. These modalities include but are not limited to leg and arm ergometry, polestriding and resistance training. These exercise therapy options have not to date been as well validated as supervised walking exercise. However, they may potentially be used in the event supervised walking exercise is not feasible or patient preference warrants an alternative exercise strategy.

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Cardiopulmonary responses to treadmill and cycle ergometry exercise in patients with peripheral vascular disease

Cited by 33 publications

References 26 publications

Repeatability of Aerobic Capacity Measurements in Parkinson Disease

Repeatability of Aerobic Capacity Measurements in Parkinson Disease

Exercise Training and Peripheral Arterial Disease

Exercise Therapy for Claudication: Latest Advances

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