The effect of exercise intensity on the response to exercise rehabilitation in patients with intermittent claudication

Gardner, Andrew W.; Montgomery, Polly S.; Flinn, William R.; Katzel, Leslie I.

doi:10.1016/j.jvs.2005.05.049

Cited by 115 publications

(108 citation statements)

References 41 publications

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“…Measured parameters of walking ability were similar following low-and high-intensity exercise programs in patients with PAD, 11 but different adaptations could derive from training in relation to intensity, frequency and duration of the working sessions.…”

Section: Discussionmentioning

confidence: 82%

Training Rather Than Walking The Test In - Train Out Program for Home-Based Rehabilitation in Peripheral Arteriopathy

Manfredini

Malagoni

Mascoli

et al. 2008

Circ J

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xercise training is an effective, low-cost therapy that improves the functional ability of patients with intermittent claudication. [1][2][3][4] Its diffusion could be favoured by models of intervention that would help ensure functional and cardiovascular improvements, patient compliance and lower costs for the healthcare system.In order to optimise these positive outcomes, the model of intervention and the prescribed exercise intensity are of primary importance. Unfortunately, specific recommendations regarding exercise prescription and programming are limited. 2 However, it is known that exercise is preferably carried out at moderate to near-maximal pain, and that better results are obtained at the hospital under the supervision of the rehabilitative team. These center-based programs for peripheral arterial disease (PAD) have been found to be more effective at improving walking ability in training up to 6 months compared with home-based programs, with unclear effect of supervision. 5,6 On the other hand, home-based programs, which are based on simple instructions about the exercise to be performed (eg, walk up to pain tolerance), in general, show higher long-term adherence to exercise, with lower cost to the healthcare system. 6 An alternative model without supervision, based on the assessment of functional capacity at hospital during monthly check-ups and a personalized prescription of exercise to be performed at home at maximal asymptomatic speed (MAS) has been developed recently. 7,8 This novel approach to rehabilitation for patients with PAD, the 'test in -train out' program (Ti-To), aims to combine the advantages of a traditional home-based program (eg, long-term adherence and lower cost) with those of a supervised program (especially, exercise at selected intensities).The Ti-To program makes use of the MAS; that is, the walking intensity below the individual pain threshold speed (PTS) 9 that combines pain-free training with functional, hemodynamic and cardiovascular adaptations. 7 The present study aimed to test the effectiveness of the Ti-To program on walking ability and hemodynamic parameters in a group of patients exercising at home at their MAS compared with patients following a traditional home-based free walking exercise (Tr-E) at self-selected speeds up to pain tolerance over a 6-month period. Background Exercise training reduces walking disability in peripheral arterial disease (PAD). This non-randomized study evaluates the effects on walking ability and hemodynamic parameters of a novel approach to home-based rehabilitation, the test in -train out program (Ti-To), compared with the traditional home-based free walking exercise (Tr-E). Methods and Results A total of 143 patients with claudication (117 men, average age 68±10 years), were included in a Ti-To (n=83) or Tr-E program (n=60). Evaluations, which were carried out upon entry and at 1, 2, 3, 4 and 6 months, included: self-reported claudication, walking ability (ie, absolute claudication distance, pain threshold speed), resting/exercise hea...

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Section: Discussionmentioning

confidence: 82%

Training Rather Than Walking The Test In - Train Out Program for Home-Based Rehabilitation in Peripheral Arteriopathy

Manfredini

Malagoni

Mascoli

et al. 2008

Circ J

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“…Increases in aerobic capacity, daily physical activity, 6-minute walk distance, and 6-minute pain-free walk distance have been demonstrated with exercise rehabilitation. 109 Large increases in maximal calf blood flow also have been documented after such exercise programs. 109,110 …”

Section: Peripheral Arterial Diseasementioning

confidence: 99%

Assessment of Functional Capacity in Clinical and Research Settings

Arena¹,

Myers²,

Williams³

et al. 2007

Circulation

471

203

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“…44,45 Although measures of plaque burden correlate with walking distance, 46,47 improvement in function occurs with exercise training despite no change in ABI. 23,28,48 Other factors such as the development of collaterals and improvements in endothelial function and skeletal muscle bioenergetics may maintain function in the presence of arterial restenosis or occlusion. 43 Thus, improving blood flow by revascularization usually has a major effect on symptoms and tissue healing, but the degree of restenosis reflects only 1 parameter related to the durability of these outcomes.…”

Section: Anatomic End Pointsmentioning

confidence: 99%

Outcomes for Clinical Studies Assessing Drug and Revascularization Therapies for Claudication and Critical Limb Ischemia in Peripheral Artery Disease

Kinlay

2013

Circulation

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The effect of exercise intensity on the response to exercise rehabilitation in patients with intermittent claudication

Cited by 115 publications

References 41 publications

Training Rather Than Walking The Test In - Train Out Program for Home-Based Rehabilitation in Peripheral Arteriopathy

Training Rather Than Walking The Test In - Train Out Program for Home-Based Rehabilitation in Peripheral Arteriopathy

Assessment of Functional Capacity in Clinical and Research Settings

Outcomes for Clinical Studies Assessing Drug and Revascularization Therapies for Claudication and Critical Limb Ischemia in Peripheral Artery Disease

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