Moderate Intensity Functional Training as Adjuvant Treatment in Patients With Peripheral Arterial Disease: A Case Report.

BACKGROUND: Traditional aerobic training and muscle resistance ("strength") training have been shown to be effective for improving functional and health-related quality of life (HRQoL) outcomes in peripheral arterial disease (PAD). However, the transfer of the current resistance exercise modes proposed to other activities of daily living (ADLs) is questionable. Moderate intensity functional training (MIFT) has emerged with the aim of achieving cardiovascular and neuromuscular adaptations simultaneously with functional exercises typical of ADLs. The effect of MIFT in patients with PAD is not yet known. Our purpose is to verify the influence of the combination of intermittent treadmill walking exercise with MIFT on functional capacity and HRQoL in patients with PAD. METHODS: Three patients with PAD participated in a novel supervised exercise therapy program of 6 weeks duration based on intermittent treadmill walking exercise and MIFT. RESULTS: After the training period, the 3 patients showed high adherence to the program (95%) and they improved total distance (TD) (25%, 9%, and 21%), claudication onset distance (COD) (56%, 19%, and 151%), total number of repetitions (33%, 24%, and 33%) and total work capacity (80%, 79%, and 72%). Also, physical component in Short Form-36 Health Survey (SF-36) and Vascular Quality of Life Questionnaire-6 (VascuQol-6) showed increases in the patients. CONCLUSIONS: The 6-week intervention in patients with PAD, based on intermittent treadmill walking exercise and MIFT, seems to improve their functional status and total work capacity in functional exercises as well as their HRQoL.

A Unique Case of Horner's Syndrome Following Subintimal Haematoma Within an Atherosclerotic Plaque.

Background and Importance We describe a patient with Horner's syndrome caused by an extensive intraparietal hematoma in the wall of the internal carotid artery confused with an arterial dissection. Detection of such pathology instead of dissection or arteritis is important as the management is different. As far as the authors know, it is the first case in which a haematoma within an atherosclerotic plaque is clinically related Horner's syndrome. Clinical Presentation A 81-year-old man presented with acute right hemiplegia and loss of vision of the left eye due to a central retinal artery occlusion. The patient underwent a computerised angiotomography which demonstrated left internal carotid artery occlusion with recanalisation after carotid bifurcation. Clinically, the patient developed a syndrome of Claude-Bernard Horner which replaced the diagnosis on the suspicion that it was a carotid artery dissection. The patient had miosis and ptosis of left eye. In the magnetic resonance angiography, an intramural of a possible hematoma was observed. It was decided to perform surgical treatment of the carotid lesion. Conclusion As this clinical case shows, there are symptomatic courtships that must be studied in detail so as not to confuse the carotid dissection with critical stenosis of the internal carotid artery.