Cardiovascular Training Effect Associated With Polestriding Exercise in Patients With Peripheral Arterial Disease

Abstract

Because individuals with claudication pain secondary to peripheral arterial disease (PAD) are limited in both walking speed and duration, the benefits of walking exercise may be insufficient to yield a cardiovascular training effect. The objectives of this analysis were to determine whether polestriding exercise training, performed by persons with PAD, would improve exercise endurance, elicit a cardiovascular training benefit, and improve quality of life (QoL). Persons (n = 49) whose claudication pain limited their exercise capacity were randomized into a 24-week polestriding training program (n = 25, 65.8 +/- 7.1 years of age) or a nonexercise attention control group (n = 24, 68.0 +/- 8.6 years of age). Those assigned to the polestriding group trained 3 times weekly. Control group subjects came to the laboratory biweekly for ankle blood pressure measurements. A symptom-limited ramp treadmill test, ratings of perceived leg pain, and QoL data (using the Short Form-36) were obtained at baseline and upon completion of training. After 24 weeks of polestriding training, subjects increased their exercise endurance from 10.3 +/- 4.1 minute to 15.1 +/- 4.5 minute. This was significantly greater than control group subjects whose exercise endurance declined (from 11.2 +/- 4.7 to 10.3 +/- 4.7 minute; P < .001). Relationships between systolic blood pressure (P < .001), heart rate (P = .04), rate pressure product (P = .05), oxygen uptake (P = .016), and perceived leg pain (P = .02) and exercise time improved from the baseline symptom-limited treadmill test to the 6-month symptom-limited treadmill test in the polestriding group compared to the control group. The improvement in the physical component summary score of the Short Form-36 was also greater in the polestriding group (P = .031). Polestriding training significantly improved the clinical indicators of cardiovascular fitness and QoL, and decreased symptoms of claudication pain during exertion.

Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication

“…The findings of significant associations between changes in submaximal exercise and peak exercise fitness parameters and improvement in walking distances with both forms of exercise training are consistent with those of previously published reports. 5,10,12,13,30 These findings suggest that improved central cardiorespiratory fitness with both arm-ergometer and lower body-exercise training defers the onset of claudication pain during walking in PAD patients and contributes significantly to improved MWD. The observed improvement of walking distances after exercise training was previously postulated to be related to local skeletal muscle metabolic changes, improved vascular endothelial reactivity, blood rheologic changes, and local and central blood flow adaptations.…”

Physiological and perceptual responses to Nordic walking in obese middle-aged women in comparison with the normal walk

“…In this way, NW could represent an attractive activity particularly for overweight or obese individuals who need to increase their intensity of walking in order to enhance their energy expenditure, but who also present walking speed limitations. Positive effects of the NW exercise program were reported not only in patients with cardiovascular diseases (Collins et al 2005), rheumatic syndrome (Strombeck et al 2007), Parkinson's disease (Baatile et al 2000;van Eijkeren et al 2008), but also in depressed patients (Suija et al 2009) and in breast cancer survivors (Sprod et al 2005). To our knowledge, effects of NW in obese middleaged individuals have never been investigated.…”

Exercise-based interventions and health-related quality of life in intermittent claudication: a 20-year (1989–2008) review

“…Of these, 24 journal articles met defined selection criteria. Authors confirmed that two publications reported on the same group of patients [7,8]. Therefore the final number of studies was 23, of which five were randomised controlled trials [7][8][9][10][11][12] (see Table 1).…”