Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication

Mika, Piotr; Konik, Anita; Januszek, Rafał; Petriczek, Tomasz; Mika, Anna; Nowobilski, Roman; Niżankowski, Rafał; Szczeklik, Andrzej

doi:10.1016/j.ijcard.2012.10.003

Cited by 45 publications

(76 citation statements)

References 28 publications

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“…52 Another randomized trial that compared moderate claudication pain treadmill exercise with pain-free exercise also showed similar results. 53 Therefore, we feel comfortable to recommend pain-free or mild pain exercise to our patients given the similar efficacy and potentially better compliance.…”

Section: Discussionmentioning

confidence: 95%

Intensive walking exercise for lower extremity peripheral arterial disease: A systematic review and meta‐analysis

Lyu

Peng

et al. 2015

Journal of Diabetes

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Background: Supervised treadmill exercise is the recommended therapy for peripheral arterial disease (PAD) patients with intermittent claudication (IC). However, most PAD patients do not exhibit typical symptoms of IC. The aim of the present study was to explore the efficacy and safety of intensive walking exercise in PAD patients with and without IC. Methods: The PubMed, Embase and Cochrane Library databases were systematically searched. Randomized controlled trials comparing the effects of intensive walking exercise with usual care in patients with PAD were included for systematic review and meta-analysis. Results: Eighteen trials with 1200 patients were eligible for the present analysis. Compared with usual care, intensive walking exercise significantly improved the maximal walking distance (MWD), pain-free walking distance, and the 6-min walking distance in patients with PAD (P < 0.00001 for all). Subgroup analyses indicated that a lesser improvement in MWD was observed in the subgroup with more diabetes patients, and that the subgroup with better baseline walking ability exhibited greater improvement in walking performance. In addition, similar improvements in walking performance were observed for exercise programs of different durations and modalities. No significant difference was found in adverse events between the intensive walking and usual care groups (relative risk 0.84; 95% confidence interval 0.51, 1.39; P = 0.50). Conclusions: Regardless of exercise length and modality, regularly intensive walking exercise improves walking ability in PAD patients more than usual care. The presence of diabetes may attenuate the improvements in walking performance in patients with PAD following exercise.

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Section: Discussionmentioning

confidence: 95%

Intensive walking exercise for lower extremity peripheral arterial disease: A systematic review and meta‐analysis

Lyu

Peng

et al. 2015

Journal of Diabetes

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“…Coutinho et al 16 explored the philosophy behind the potential influence of EF in the functional decline of PAD patients. Various clinical trials followed and showed that greater physical activity and exercise can enhance EF as measured by FMD 25–27 . We therefore confirm through this cross-sectional study that EF assessed by brachial artery FMD could serve as a risk marker for symptom severity and impaired physical activity in patients with PAD.…”

Section: Discussionmentioning

confidence: 99%

Walking disability in patients with peripheral artery disease is associated with arterial endothelial function

Grenon

Chong

Alley

et al. 2014

Journal of Vascular Surgery

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Objective Patients with peripheral artery disease (PAD) have varying degrees of walking disability that does not completely correlate with ankle brachial index (ABI) or angiographic anatomy. We hypothesized that endothelial function (EF) is an independent predictor of symptom severity in PAD patients. Methods This was a cross-sectional study of PAD (N=100) patients presenting to a vascular surgery clinic. All patients received ABI testing and brachial artery flow-mediated, endothelium-dependent, vasodilation (FMD) to assess arterial EF. Symptom severity and walking disability reported by Rutherford category was based on the patient’s self-report during clinic visit, recorded by the investigator-vascular surgeons. Demographic, biochemical and physiologic parameters were entered into regression equations to determine association with symptom severity. Results Mean age was 66 ± 8 and 43% had diabetes. Mean FMD was 7.4% indicating impaired EF. EF progressively declined as Rutherford category increased (p=0.01). Brachial artery FMD, ABI, systolic blood pressure, C-reactive protein, LDL, HDL, beta-blocker use and a history of diabetes or coronary artery disease (CAD) were all associated with Rutherford category (all p<0.05). After multivariable regression, EF (p<0.02) and ABI (p<0.0001) were independently associated with walking disability. When the cohort was restricted to claudicants (n=73), EF remained associated with walking disability after adjustment for other covariates (p=0.0001). Conclusion Symptom severity in PAD is multifactorial, reflecting both impaired hemodynamics and vascular dysfunction. This is the first report demonstrating that walking disability in PAD is associated with arterial EF. The mechanistic link underlying these observations remains to be defined.

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“…Alguns estudos relataram redução da inflamação sistêmica após o TC (SAETRE et al, 2011;NOWAK et al, 2012;JANUSZEK et al, 2014). Em contrapartida, Schlager et al (2012), Delaney e Spark (2015) e Mika et al (2013) observaram que o treinamento não promoveu nenhum efeito anti-inflamatório nesses indivíduos. Em relação aos marcadores de estresse oxidativo, as informações são bastante escassas.…”

Section: Introductionunclassified

Treinamento de caminhada na claudicação intermitente: respostas hemodinâmicas, autonômicas, inflamatórias e de estresse oxidativo em repouso e após uma caminhada máxima

Lima¹

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AGRADECIMENTOS À Deus, pela saúde, por tantas bênçãos e por me manter firme ao longo dessa jornada. À minha querida esposa, Manuele, por me aconselhar e estar presente em todos os momentos, nos mais fáceis e, principalmente nos mais difíceis, me apoiando e incentivando. Certamente, não seria possível desenvolver esse trabalho sem sua companhia. Obrigado por aguentar meu mau humor e estresse durante esses 4 anos de doutorado. Então, essa tese também é sua! Te amo demais! Aos meus amados pais, Ricardo e Ione, e meu irmão, Cadinho, por todo incentivo e apoio incondicional, não só durante o doutorado, mas também ao longo de toda minha jornada acadêmica. Essa tese só existe por conta de todo carinho, amor e orações investidos por vocês! Obrigado porque apesar de toda saudade e distância, vocês foram meu porto seguro durante todos esses anos. Amo vocês. À minha segunda mãe e sogra, Marluce, e ao meu cunhado, Pedro, por todo amor, incentivo e hospitalidade, além dos incríveis almoços baianos. Tenho vocês guardados no meu coração, obrigado por todos os conselhos! À minha orientadora, profa. Cláudia Forjaz, pela oportunidade de poder fazer parte do LAHAM e acreditar nesse projeto desafiador. Além de todo o suporte técnico e científico, sendo sem dúvidas um exemplo de orientadora e acima de tudo, um exemplo de profissional dedicada. Ao prof. Raphael Ritti Dias, por ter me aceitado como aluno ainda na iniciação científica, o que modificou e abriu completamente minha mente para a ciência. Além disso, agradeço por sua parceria e conselhos que contribuíram para o meu crescimento acadêmico e chegada até o doutorado. Aos amigos do grupo da claudicação, principalmente Natan, Marcel e Beto Burns, que contribuíram bastante para o desenvolvimento desse trabalho, durante as coletas e análise de dados. Certamente, finalizar esse trabalho sem a ajuda de ambos não seria possível.

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Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication

Cited by 45 publications

References 28 publications

Intensive walking exercise for lower extremity peripheral arterial disease: A systematic review and meta‐analysis

Intensive walking exercise for lower extremity peripheral arterial disease: A systematic review and meta‐analysis

Walking disability in patients with peripheral artery disease is associated with arterial endothelial function

Treinamento de caminhada na claudicação intermitente: respostas hemodinâmicas, autonômicas, inflamatórias e de estresse oxidativo em repouso e após uma caminhada máxima

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