Exercise prescription using the heart of claudication pain onset in patients with intermittent claudication

Abstract

OBJECTIVE:To assess the acute metabolic and cardiovascular responses to walking exercise at an intensity corresponding to the heart rate of claudication pain onset and to investigate the effects of a 12-week walking training program at this intensity on walking capacity.METHODS:Twenty-nine patients with intermittent claudication were randomly allocated to the walking training (n = 17) or control (CO, n = 12) group. The walking training group performed an acute exercise session comprising 15×2-min bouts of walking at the heart rate of claudication pain onset, with 2-min interpolated rest intervals. The claudication symptoms and cardiovascular and metabolic responses were evaluated. Walking training was then performed at the same intensity twice each week for 12 weeks, while the control group engaged in twice weekly stretching classes. The claudication onset distance and total walking distance were evaluated before and after the interventions. Brazilian Registry Clinical Trials: RBR-7M3D8W.RESULTS:During the acute exercise session, the heart rate was maintained within tight limits. The exercise intensity was above the anaerobic threshold and >80% of the heart rate peak and VO2peak. After the exercise training period, the walking exercise group (n = 13) showed increased claudication onset distance (309±153 vs. 413±201m) and total walking distance (784±182 vs. 1,100±236m) compared to the control group (n = 12) (p<0.05).CONCLUSION:Walking exercise prescribed at the heart rate of claudication pain onset enables patients with intermittent claudication to exercise with tolerable levels of pain and improves walking performance.

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

“…. Eighteen studies with sample sizes ranging from 18 to 252 were eligible for the present systematic review . The baseline characteristics of the studies included are summarized in Table .…”

“…The walking speed was no less than 3.2 km/h with metabolic equivalents (MET)/min that of at least 2.5. In terms of exercise modality, the patients were encouraged to walk to moderate‐to‐maximal pain in most studies, whereas four studies were preset to no‐to‐mild pain …”

“…Eighteen studies with sample sizes ranging from 18 to 252 were eligible for the present systematic review. [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] The baseline characteristics of the studies included are summarized in Table 1. The meta-analysis included 1200 PAD patients in all, with a mean age of 67.1 ± 9.4 years, and 67% of them were male.…”

“…In terms of exercise modality, the patients were encouraged to walk to moderate-tomaximal pain in most studies, whereas four studies were preset to no-to-mild pain. 21,32,33,36…”

Post-Walking Exercise Hypotension in Patients with Intermittent Claudication

“…HR coinciding with claudication pain onset was used to set the intensity of intermittent WE in the experimental condition of the study (see later section). This exercise intensity was shown to be above anaerobic threshold and to evoke tolerable levels of claudication pain during repeated 2-min bouts of WE (8).…”