Rejuvenating Mobility: Impact of Concurrent Exercise on Functional Claudication Distance and Vascular Health among Patients with T2DM-Associated PAD

Abstract

Background: Globally, the diabetes epidemic has increased in the general population over the last few decades. Despite the higher prevalence of Type-II DM, evidence about Diabetes-related vascular complications is scarce. Therefore, this study aims to determine appropriate exercise training in clinical settings effectively, reducing risk factors for T2DM-associated PAD patients. Methods: At the Department of Rehabilitation Sciences of Dr. Ziauddin Hospital Karachi, a randomized, single-blinded, two-arm trial was conducted from July to September 2023. Eighty patients with T2DM-associated PAD were recruited and randomly assigned into two groups Using the sealed envelope approach: Group A (n=40) and Group B (n=40). For 12 weeks, participants in Group B performed Aerobic Training (AT), while Group A participated in Concurrent Training (CT) 3 times a week. Functional Claudication Distance (FCD) and VascuQol-6 were measured pre and post-12-week intervention for measuring functional capacity and vascular health. Results:Findings revealed that CT training groups significantly improved FCD and VascuQol-6 after 12 weeks (p<0.000). Subsequently, findings showed that the CT group showed more significant improvement than AT in improving FCD (p=0.013, CT: pre: 203.33±1.78, post: 230.65±7.72, AT: pre: 203.08±2.2, post: 214.13±5.1) and VascuQol-6 (p=0.0001, CT: pre: 10.60±2.11, post: 19.88±1.24, AT: pre: 9.53±2, post: 14.33±1.97). Conclusion: Patients’ reported vascular health and FCD significantly improved by the CT than the AT group. Therefore, CT appears to be an exceptionally beneficial therapeutic strategy for the management of Fontaine’s stage II, a PADassociated with T2DM. Keywords: Claudication Distance, Diabetic Vascular Complication, Peripheral Artery Disease, Type-2 Diabetes Mellitus, Vascular Quality of Life.