Upper versus lower limb exercise training in patients with intermittent claudication: A systematic review

Abstract

Lower extremity (LE) exercise training has been shown to contribute to improvements in Maximum Walking Distance (MWD), Claudication Distance (CD), peak oxygen uptake (VO 2peak ) and Quality of Life (QoL) in patients with intermittent claudication (IC). However, little is known regarding the efficacy of upper extremity (UE) exercise training in comparison to the widely used LE training. The objective of this systematic literature review is to identify and synthesize the available literature on the effects of UE versus LE exercises using the International Classification of Functioning (ICF) conceptual framework. A total of 6 randomized controlled trials comparing UE to LE exercises were included in this study. Two of the articles were considered to be of high quality using the PEDro grading list. Both UE and LE training groups demonstrated significant improvements in MWD, CD, VO 2peak and QoL in comparison to the control group but LE was not better than UE training. This supports the use of UE training as an alternative to LE, which could provide symptomatic relief to patients with IC without the discomfort caused during the LE training.

Differential Diagnosis and Treatment of Restless Legs Syndrome: A Literature Review

“…Similarly, skin alterations may also be noted in vascular or neurogenic claudication [ 17 ]. Vascular intermittent claudication is a consequence of inadequate delivery of oxygenated blood flow to the peripheral tissues [ 18 ]. It is a frequent cause of leg pain and discomfort [ 18 ].…”

“…Vascular intermittent claudication is a consequence of inadequate delivery of oxygenated blood flow to the peripheral tissues [ 18 ]. It is a frequent cause of leg pain and discomfort [ 18 ]. In contrast to RLS, intermittent claudication occurs during activity, is relieved by rest, and lacks the urge to move [ 19 ].…”

On the Cutting Edge: Wound Care for the Endovascular Specialist

“…A review of six recent RCTs demonstrated that vigorous upper extremity exercise (arm cranking for 40-70 minutes two to three times per week for 6-24 weeks) results in improvements in mean lower leg peak oxygen consumption, walking distance, claudication distance, and quality-of-life metrics when compared to lower extremity exercise. 50 Given these findings, upper extremity and body exercise may be an alternative method of exercising CLI patients.…”

A Single Bout of Arm-crank Exercise Promotes Positive Emotions and Post-Exercise Hypotension in Patients with Symptomatic Peripheral Artery Disease

“…10,11 Therefore, non-painful modes of exercise, such as arm cranking, have emerged as a promising approach for patients with PAD. 12,13 Previous studies have reported that arm crank exercise significantly increased walking capacity and quality of life, 14 which may improve functional capacity in patients with PAD. However, the emotions experienced during this mode of exercise, which may influence exercise adherence and ultimately reduce cardiovascular risk, have not been examined previously.…”