ABSTRACT
The authors assessed efficacy of treating patients with atherosclerosis obliterans of lower-limb arteries using the method of walking training. Our prospective study included a total of 84 patients suffering from intermittent claudication. They were divided in two groups. The Study Group (Group I) comprised 64 patients undergoing comprehensive treatment including walking training (WT) and the Control Group (Group II) consisted of 20 patients treated without a physical training programme. The patients were followed up monthly during three months, with registration of the pain-free walking distance (PFWD), maximum walking distance (MWD), and the ankle-brachial index (ABI). There were no baseline statistically significant differences between Group I and Group II patients in the parameters examined. The Study Group patients were found to have a considerable increase in the PFWD and MWD values, with the statistical significance of differences from the Control Group patients observed as early as at one month of treatment. The baseline PFWD value in the Study Group amounted to 132.4±14.7 m, being at 3 months 259.7±29.6 m (p<0.05); the MWD value in the Study Group initially equalled 170.2±12.3 m, amounting at 3 months to 364.6±39.2 m (p<0.05). The Study Group patients by the end of follow up were also found to have an increase in the ankle-brachial index by nearly 25% from the baseline level. The carried out treatment resulted in an increase in the number of patients with less severe stages of arterial insufficiency: initially stage IIa was diagnosed in 18 (28.2%) patients and at 3 months in 47 (73.4%) patients, with stage IIb being diagnosed in 46 (71.8 %) and 17 (26.6%) subjects, respectively. A conclusion was drawn that training walking considerably improved clinical manifestations of the disease. Taking into consideration availability of this therapeutic method, it should be recommended for patients suffering from intermittent claudication in long-term courses and in all cases where there are no contraindications thereto.
Subject(s)
Education/methods , Exercise Therapy/methods , Intermittent Claudication , Lower Extremity/blood supply , Walking , Aged , Conservative Treatment/methods , Efficiency, Organizational , Exercise Tolerance , Female , Humans , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Intermittent Claudication/therapy , Male , Middle Aged , Severity of Illness IndexABSTRACT
Metabolic therapy is one of several therapeutic strategies that can be used in patients with lower limb chronic obliterative arterial disease (COAD). Tanakan (EGb76) has demonstrated high efficiency and safety in 9 controlled clinical trials and author's clinical series in patients with lower limb COAD. Improvement with significant increase of pain-free walking distance and beneficial safety profile was observed in all cases. Tanakan (EGb76) is highly effective conventional therapeutic agent for memory and attention disorders, dizziness and balance disturbances in adults and elderly patients. Given a common concomitance of these disorders and lower limb COAD, Tanakan can be recommended as a drug of choice for treatment of chronic obliterative arteriopathy.