Real‐life adaptations in walking patterns in patients with established peripheral arterial disease assessed using a global positioning system in the community: a cohort study

Klonizakis, Markos; Bianchi, Stephen; Gernigon, Marie; Ábrahám, Pierre; Nawaz, Shah

doi:10.1111/cpf.12501

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…A number of studies have used GPS technology to study free-living walking adaptations in people with IC [25][26][27][28]. However, these studies have explored walking within a constrained environment and time period, for example over a fixed period of 45-60 min recorded in researcher-designated public parks.…”

Section: Introductionmentioning

confidence: 99%

Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study

Iveson

Abaraogu

Dall

et al. 2023

IJERPH

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Individuals with intermittent claudication (IC) are less physically active than their peers, but how this varies with location is unclear. Individuals with IC and matched controls [sex, age ±5 years, home < 5 miles] wore an activity monitor (activPAL) and carried a GPS device (AMOD-AGL3080) for 7 days. GPS data categorised walking events as occurring at home (<=50 m from home co-ordinates) or away from home, and indoors (signal to noise ratio <= 212 dB) or outdoors. Number of walking events, walking duration, steps and cadence were compared between groups and each location pair using mixed model ANOVAs. In addition, the locus of activity (distance from home) at which walking was conducted was compared between groups. Participants (n = 56) were mostly male (64%) and aged 54–89 years. Individuals with IC spent significantly less time walking and took fewer steps than their matched controls at all locations, including at home. Participants spent more time and took more steps away from home than at home, but were similar when walking indoors and outdoors. The locus of activity was significantly smaller for individuals with IC, suggesting that it is not just physical capacity that influences walking behaviour, and other factors (e.g., social isolation) may play a role.

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Section: Introductionmentioning

confidence: 99%

Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study

Iveson

Abaraogu

Dall

et al. 2023

IJERPH

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“… 1 This is important as symptoms usually worsen with time. 2 Guidelines for these programs recommend interval walking as the primary mode of exercise in addition to other modes of aerobic exercise (e.g., upper body ergometry or cycling) and resistance exercise. 3 However, uptake and adherence to supervised exercise programs are poor, 4 in part due to high pain and the effort associated with exercise, which presents a substantial motivational challenge for patients.…”

Section: Introductionmentioning

confidence: 99%

Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial

Parkington,

Broom,

Maden-Wilkinson

et al. 2023

Vasc Med

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Background: Claudication is a common and debilitating symptom of peripheral artery disease, resulting in poor exercise performance and quality of life (QoL). Supervised exercise programs are an effective rehabilitation for patients with claudication, but they are poorly adhered to, in part due to the high pain and effort associated with walking, aerobic, and resistance exercise. Low-intensity resistance exercise with blood flow restriction (BFR) represents an alternative exercise method for individuals who are intolerant to high-intensity protocols. The aim of this study was to evaluate the feasibility of a supervised BFR program in patients with claudication. Methods: Thirty patients with stable claudication completed an 8-week supervised exercise program and were randomized to either BFR ( n = 15) or a control of matched exercise without BFR (control; n = 15). Feasibility, safety, and efficacy were assessed. Results: All success criteria of the feasibility trial were met. Exercise adherence was high (BFR = 78.3%, control = 83.8%), loss to follow up was 10%, and there were no adverse events. Clinical improvement in walking was achieved in 86% of patients in the BFR group but in only 46% of patients in the control group. Time to claudication pain during walking increased by 35% for BFR but was unchanged for the control. QoL for the BFR group showed improved mobility, ability to do usual activities, pain, depression, and overall health at follow up. Conclusion: A supervised blood flow restriction program is feasible in patients with claudication and has the potential to increase exercise performance, reduce pain, and improve QoL. (Clinicaltrials.gov Identifier: NCT04890275)

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“…Given the effectiveness of supervised exercise programmes, the poor uptake and compliance to these programmes is a great concern. Therefore, as walking exercise is painful for patients with IC and exercise performance reduces with time if no treatment is followed (Klonizakis et al, 2018), alternative and preferably claudication pain free exercise modes must be available. This requires further research on novel exercise modes both on safety, feasibility and effectiveness.…”

Section: Statement Of Originalitymentioning

confidence: 99%

Feasibility of Blood Flow Restriction Resistance Exercise for Patients with Intermittent Claudication

Parkington¹

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Intermittent Claudication (IC) is a common and debilitating symptom of peripheral arterial disease (PAD) resulting in significant reduction in exercise performance and quality of life. Supervised exercise programmes are part of first-line treatment for IC proving highly effective for improving exercise performance and alleviating symptoms. Despite this, supervised exercise programmes have poor adherence in part to patients’ inability to tolerate IC related pain during walking exercise highlighting the need for alternative exercise modes. Blood flow restriction resistance exercise (BFR-RE) is a technique that facilitates local muscle hypoxia during resistance exercise to induce hypertrophy, strength, and muscular endurance. BFR-RE presents an exciting alternative modality to improve exercise performance in IC patients though requires research on safety, feasibility, and efficacy. This research explored the acute perceptual, affective, and physiological responses to resistance exercises performed at low-load with BFR (LL-BFR), low-load (LL) and moderate-load (ML) in healthy young and older adults; examined the inter-day reliability of a physical function test battery in IC patients sought to determine suitability of the test battery and smallest worthwhile change for each measure; and conducted a randomised controlled trial to evaluate the safety, feasibility, and efficacy of an 8-week LL-BFR resistance exercise programme in IC patients. No adverse events were recorded during this body of work that was attributed to the protocols or procedures administered. LL-BFR was shown to be more demanding than LL and ML predominately through increased pain (p ≤ 0.024, d = 0.8 – 1.4). However, this did not lead to decrements in affective response and fatigue post exercise. Excellent reliability (≥ 0.92 ICC) of the physical function test battery was observed in IC patients and the minimum likely change (76% chance) was calculated for each measure. The feasibility trial observed high adherence (LL-BFR = 78.3%, LL = 83.8%) and completion rates (LL-BFR = 93%, LL = 87%). Significant clinical improvement (>35 m) in the six-minute walk test (6MWT) was achieved in 86% of patients in LL-BFR but only 46% of patients in LL. Additionally, time to claudication pain during 6MWT was likely increased (44.7 s [20.8, 68.6]) for LL-BFR and likely unchanged (4.4 s [-32.4, 23.6]) for LL. This thesis supports BFR-RE as a safe, feasible and potentially effective exercise mode for IC patients.

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Real‐life adaptations in walking patterns in patients with established peripheral arterial disease assessed using a global positioning system in the community: a cohort study

Abstract: Given the reported symptom progression, we advocate early intervention (e.g. exercise interventions) combined with frequent patient monitoring in attempts to maintain or improve walking ability.

Cited by 5 publications

References 26 publications

Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study

Walking Behaviour of Individuals with Intermittent Claudication Compared to Matched Controls in Different Locations: An Exploratory Study

Low-intensity resistance exercise with blood flow restriction for patients with claudication: A randomized controlled feasibility trial

Feasibility of Blood Flow Restriction Resistance Exercise for Patients with Intermittent Claudication

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