The primary objective of this study was to compare the effects on muscle metabolism of two types of aerobic training, with and without a load on the lower limbs, in adults with peripheral arterial disease (PAD). A simple blind randomized clinical trial was conducted using two groups: conventional aerobic (CG) and modified aerobic with a load on the lower limbs (MG). Both groups underwent training by walking three times a week over a 12-week period. The ratings of muscle metabolism were determined after a treadmill test with constant velocity and inclination concomitant with the use of near infrared spectroscopy (NIRS). Altogether 40 individuals with PAD (CG = 65.45 ± 10.60 and MG = 63.10 ± 10.54) were included in the study. After the intervention, in both groups, there was a reduction in the relative time to recovery (p = 0.002), an improvement in the re-oxygenation rate (p = 0.017), an increased time of resistance after reaching the lowest muscle oxygen saturation (StO2) (p < 0.001), an increase in the distance walked (p < 0.001), and an improvement of the walking economy relative to StO2 (p < 0.001). After 12 weeks of training, an improvement in the deoxygenation rate was observed in both groups (p = 0.002), but with a greater magnitude in the CG (p = 0.017). Only the CG presented an increase in time to reach the lowest StO2 on the treadmill after the intervention (p = 0.010). The traditional aerobic training was superior to the modified training in relation to the improvement of muscle metabolism in patients with PAD.

Introdução: O Shuttle walking test (SWT) foi originalmente desenvolvido para indivíduos com doença pulmonar obstrutiva crônica (DPOC). Sua aplicação na avaliação funcional em outras condições de saúde vem sendo empregada. Objetivo: Fazer uma revisão de literatura sobre o uso do Shuttle walking test na avaliação da capacidade funcional. Materiais e Métodos: A revisão da literatura foi realizada nas bases de dados Medline, Lilacs e Scielo considerando a combinação do descritor principal Shuttle walking test com os descritores em português e inglês: validade, reprodutibilidade, confiabilidade, sensibilidade, diferença mínima clinicamente significativa e prognóstico. Resultados: Foram selecionados 37 artigos que apresentavam o SWT como desfecho cardiorrespiratório de interesse nas seguintes condições de saúde: insuficiência cardíaca, doença arterial coronariana, DPOC, transplante cardíaco, doença arterial obstrutiva periférica, fibrose cística, fibrose pulmonar idiopática e pacientes com marcapasso. Conclusão: O SWT é um teste de caminhada válido, confiável e seguro para a avaliação da capacidade funcional em diversas condições de saúde. É útil na prática clínica para avaliar respostas a intervenções e prognóstico. Palavras-chave: teste de esforço; condicionamento físico humano; fisioterapia.

HighlightsBilateral HRT reference values were established, stratified by age and gender.Bilateral HRT reference values may be used as a basis for research and clinical practice.

Introduction Individuals with chronic venous insufficiency (CVI) have muscle pump dysfunction and reduced functionality. However, studies are inconsistent in proving whether a particular test can assess muscle functional capacity. Therefore, the aim of this study was to evaluate whether the heel-rise test (HRT) is able to explain functional capacity in patients with CVI. Materials and methods Subjects with CVI aged between 20 and 59 years old were selected for this study. All participants were classified by means of the Clinical Anatomy Etiology Pathophysiology Classification of Chronic Venous Disease (CEAP). The HRT and the shuttle walk test (SWT) were performed. Descriptive statistics, Spearman correlation, linear models and regression variance analysis (one-way ANOVA) were used for data analysis. Significance was set at alpha ≤ 5%. Results 79 subjects were included in the study (38.79 ± 1.34 years). The HRT was able to explain functional capacity only in individuals aged between 50-59 years (R2 = 0.60, p = 0.0001). The heel-rise test was not sensitive to detect differences between the CEAP classes analyzed (p > 0.05). Conclusion The HRT was able to explain functional capacity in individuals aged between 50-59 years, and it can be applied in clinical practice for the functional evaluation of patients with CVI with mild severity in this age range.

IntroductionThe Heel-Rise Test (HRT) is a clinical instrument relevant to vascular rehabilitation that has been proposed to assess the function of the triceps surae muscle. To use HRT in the assessment of individuals with peripheral arterial occlusive disease (PAOD), its ability to detect differences in the functional performance of patients with PAOD must be verified.AimTo verify whether the test is sensitive in differentiating between individuals with PAOD with distinct functional capacities.Materials and methodsA transversal study in which individuals with PAOD were assessed using the HRT, the Walking Impairment Questionnaire (WIQ), and the Shuttle Walk Test. The following variables were analyzed: number of plantar flexions performed in the HRT (time in seconds) and velocity (plantar flexions per second) when performing plantar flexions up to the point of volunteer fatigue, maximum distance walked in the Shuttle Walk Test, and scores obtained in each WIQ domain.ResultsTwenty-five individuals (14 male) were included in the study, with a mean age of 63.36 ± 9.83 years. The variables number of plantar flexions and time to perform the HRT were sensitive enough to differentiate between distinct functional capacities in individuals with PAOD (P = 0.003 and P = 0.009, respectively). However, this result was not found for the variable of velocity in the HRT. The number of plantar flexions in the HRT was sensitive enough to differentiate individuals of extreme classes on the WIQ domain, stairs (P = 0.008).ConclusionThe HRT can be applied in clinical practice as a valid assessment of the distinct function capacities of individuals with PAOD.

Background Peripheral pump dysfunction is important in identifying manifestations of chronic venous insufficiency. The association with disease severity may define better treatment strategies. Objective To evaluate the association between peripheral muscular pump performance by heel-rise test, age, physical activity, use of compression stockings, and chronic venous insufficiency clinical severity. Methods Subjects with chronic venous insufficiency were enrolled in the study ( n = 172) and evaluated by clinical–etiology–anatomy–pathophysiology severity and heel-rise test. Results In model 1 of logistic regression, number of heel-rise test repetitions, age, and physical activity explained 47% of clinical–etiology–anatomy–pathophysiology severity ( p = 0.0001), physical activity contributed the most. In model 2, heel-rise test repetition rate, age, and physical activity explained 46.4% of clinical–etiology–anatomy–pathophysiology severity ( p = 0.0001), repetition rate contributed the most. Conclusion: There was an inverse association between muscular pump performance and physical activity with clinical–etiology–anatomy–pathophysiology severity, muscular pump repetition rate contributed to a less severe outcome.

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&lt;LEAP&gt; Highlights the findings and application of Cochrane reviews and other evidence pertinent to the practice of physical therapy. The Cochrane Library is a respected source of reliable evidence related to health care. Cochrane systematic reviews explore the evidence for and against the effectiveness and appropriateness of interventions—medication, surgery, education, nutrition, and exercise—and the evidence for and against the use of diagnostic tests for specific conditions. Cochrane reviews are designed to facilitate the decisions of clinicians, patients, and others in health care by providing a careful review and interpretation of research studies published in the scientific literature. Each article in this Physical Therapy (PTJ) series will summarize a Cochrane review or other scientific evidence resource on a single topic and will present clinical scenarios based on real patients to illustrate how the results of the review can be used to directly inform clinical decisions. This article focuses on the effectiveness of supervised exercise therapy for intermittent claudication. Can supervised exercise therapy help a person with intermittent claudication?