Effects of regular exercise program in patients with intermittent claudication

ABSTRACT

Peripheral arterial disease [PAD] is a leading cause of morbidity due to ambulatory limitations associated with intermittent claudication. Both smoking and family history of cardiovascular disease are independently associated with a significantly increased risk for peripheral atherosclerosis in adults. The ankle-brachial index [ABI] is a useful tool for the diagnosis of PAD. The ability to walk for a distance is a quick and inexpensive performance- measure, and an important component of quality of life, since it reflects the capacity to undertake day-to-day activities or, conversely, functional limitation. Conservative management was advocated for claudicants with mild-to-moderate symptoms, while interventional treatment was confined to patients with severe symptoms. The methods of exercise prescription include establishing a training intensity that produces moderate claudication pain within the first five minutes of treadmill walking. Exercise treatment can produce a significant and clinically meaningful increase in walking distance in most patients with claudication who adhere to it. The aim of the study was to evaluate the effect of a supervised exercise program on ABI and walking distance in patients with intermittent claudication. Thirty-two patients [22 males and 10 females] aged 54.62 +/- 5.23 years complained from intermittent claudication due to PAD secondary to atherosclerosis were participated in the study. Patients were categorized into two groups; exercise group, which included 12 males and 5 females; and control group included 10 males and 5 females. ABI was calculated after 15 minutes of supine rest. By using a h and held Doppler with a 5-MHz probe, blood pressure [BP] measurements were obtained. The 6-minute walk test was conducted according to st and ardized protocol. Initial claudication distance [ICD] and absolute claudication distance [ACD] were measured for all participants. Patients of exercise group were enrolled in a regular treadmill exercise program for 12 weeks, three times per week, under physical therapy supervision in a st and ard hospital gym. Patients of the control group were asked to practice their usual life style activities. The same test measures were applied at the end of the study program for both groups. On comparing the final evaluations for exercise and control groups, it was found a significant [p<0.05] difference of ABI, ICD and ACD. ABI was 0.9310.24 vs. 0.68 +/- 0.36, ICD was 283.37 +/- 15.65 meter vs. 202.88 +/- 12.87 meter and ACD was 540.65 +/- 26.38 meter vs. 458.51 +/- 23.72 meter for both groups respectively. BMI of both groups showed insignificant [p>0.05] difference, where it was 24.4515.34 Kg/m[2] vs. 26.9314.61 Kg/m[2] respectively. Exercise rehabilitation is an effective therapy to improve functional independence in patients with PAD limited by intermittent claudication. Exercise therapy decreases claudication symptoms, improve functional ability, and greatly enhance quality of life. Supervised exercise program is effective for improving claudication symptoms