Different Outcomes after Revascularization or Standard Supervised Exercise Treadmill Training of Claudicating Patients with Peripheral Artery Disease

Li, Shuai; Myers, Sara A.; Thompson, Jonathan R.; Kim, Julian; Koutakis, Panagiotis; Williams, Mark A.; Zhu, Zhen; Schieber, Molly; Lackner, Timothy; Willcockson, Gregory; Shields, Christina; Brunette, Katyarina E.; DeSpiegelaere, Holly; Pipinos, Iraklis I.; Casale, George P.

doi:10.1016/j.jvssci.2020.11.019

Cited by 3 publications

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“…In addition, exercise bouts have been shown to increase ROS biomarkers in PAD patients, and some studies have shown that exercise can lead to pathologic changes in skeletal muscle and skeletal muscle injury [ 62 , 63 , 64 ]. This observation has led some researchers to suggest the addition of antioxidant supplementation along with exercise interventions to alleviate exercise-induced oxidative stress [ 65 , 66 ].…”

Section: Peripheral Artery Diseasementioning

confidence: 99%

Phytochemicals as Therapeutic Interventions in Peripheral Artery Disease

et al. 2021

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Peripheral artery disease (PAD) affects over 200 million people worldwide, resulting in significant morbidity and mortality, yet treatment options remain limited. Among the manifestations of PAD is a severe functional disability and decline, which is thought to be the result of different pathophysiological mechanisms including oxidative stress, skeletal muscle pathology, and reduced nitric oxide bioavailability. Thus, compounds that target these mechanisms may have a therapeutic effect on walking performance in PAD patients. Phytochemicals produced by plants have been widely studied for their potential health effects and role in various diseases including cardiovascular disease and cancer. In this review, we focus on PAD and discuss the evidence related to the clinical utility of different phytochemicals. We discuss phytochemical research in preclinical models of PAD, and we highlight the results of the available clinical trials that have assessed the effects of these compounds on PAD patient functional outcomes.

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Section: Peripheral Artery Diseasementioning

confidence: 99%

Phytochemicals as Therapeutic Interventions in Peripheral Artery Disease

et al. 2021

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“…Guidelines for effective SET programs include being conducted continuously, for at least four months, consist of three sessions per week lasting 30 min or more, and with an intensity that encourages patients to walk until near the maximal threshold [ 11 ]. However, only limited improvement in gait parameters have been reported after the SET [ 11 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Joint Angle Variability Is Altered in Patients with Peripheral Artery Disease after Six Months of Exercise Intervention

Fallahtafti

Salamifar

Hassan

et al. 2022

Entropy

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Supervised exercise therapy (SET) is a conservative non-operative treatment strategy for improving walking performance in patients with peripheral artery disease (PAD). Gait variability is altered in patients with PAD, but the effect of SET on gait variability is unknown. Forty-three claudicating patients with PAD underwent gait analysis before and immediately after a 6-month SET program. Nonlinear gait variability was assessed using sample entropy, and the largest Lyapunov exponent of the ankle, knee, and hip joint angle time series. Linear mean and variability of the range of motion time series for these three joint angles were also calculated. Two-factor repeated measure analysis of variance determined the effect of the intervention and joint location on linear and nonlinear dependent variables. After SET, walking regularity decreased, while the stability remained unaffected. Ankle nonlinear variability had increased values compared with the knee and hip joints. Linear measures did not change following SET, except for knee angle, in which the magnitude of variations increased after the intervention. A six-month SET program produced changes in gait variability toward the direction of healthy controls, which indicates that in general, SET improved walking performance in individuals with PAD.

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Intermittent Claudication and Asymptomatic Peripheral Arterial Disease

Rümenapf

Morbach

Schmidt

et al. 2020

Deutsches Ärzteblatt International

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eripheral arterial disease (PAD) is caused by atherosclerotic lesions in the pelvic and leg arteries. The incidence of atherogenic risk factors is rising worldwide (1), mainly due to the increasing age of the population. PAD is the third most common sequelae of arteriosclerosis after coronary heart disease and cerebrovascular diseases (1, 2). As a marker disease, it points to a high cardiovascular risk (3). It advances in stages (Table), initially causing a reduction in pain-free walking distance (intermittent claudication, IC), which impairs quality of life and ability to work. At the stage of critical limb ischemia (CLI), pain at rest occurs, followed ultimately by tissue necrosis and amputation. The majority of symptomatic PAD patients suffer from IC (4). Current guidelines (3-8) recommend lifestyle changes and risk factor management for all stages of PAD. In IC, vasoactive drugs and supervised exercise training (SET) are considered standard to achieve risk-free improvement in walking distance. Revascularization (percutaneous transluminal angioplasty [PTA]/stenting, vascular surgery) is not recommended at the asymptomatic stage, is recommended only in exceptional cases in IC (e.g., if conservative treatment fails), but is urgently recommended in CLI. Angioplasty for IC is not known to achieve better medium-and long-term outcomes compared to SET (3, 9). Unfortunately, in Germany as well as other countries (9), SET remains a largely theoretical option that is unachievable in a practical sense. Therefore, SET cannot be used as a yardstick for the results of arterial revascularization. Moreover, although revascularized patients are relieved of their symptoms in the immediate and longer term, most clinical studies have compared only the medium-and long-term benefit to SET. The primary objective of this review article is to investigate whether guideline-compliant conservative treatment for IC can be recommended as an evidencebased approach in view of its limited efficacy, availability, practicability, and acceptance among patients. In light of the treatment reality in Germany, the benefit of arterial revascularization in IC is evaluated, particularly in combination with SET. Methods In 2014, the German Society for Angiology (Deutsche Gesellschaft für Angiologie) performed an extensive Summary Background: The conservative treatment of peripheral arterial disease (PAD), as recommended in current guidelines, encompasses measures such as lifestyle modification and risk-factor management. In addition, in patients with vasogenic intermittent claudication (IC), it is recommended that patients first be given drugs to improve perfusion and undergo supervised gait training. Revascularization is not recommended for asymptomatic persons, but it is considered mandatory for patients with critical ischemia. In this article on conservative and revascularizing treatment strategies for IC, we address the following questions: whether all treatment options are available, how effective they are, and whether the reality of treatment for ...

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Different Outcomes after Revascularization or Standard Supervised Exercise Treadmill Training of Claudicating Patients with Peripheral Artery Disease

Cited by 3 publications

References 0 publications

Phytochemicals as Therapeutic Interventions in Peripheral Artery Disease

Phytochemicals as Therapeutic Interventions in Peripheral Artery Disease

Joint Angle Variability Is Altered in Patients with Peripheral Artery Disease after Six Months of Exercise Intervention

Intermittent Claudication and Asymptomatic Peripheral Arterial Disease

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