Abstract 2760: Both Arm Ergometry and Treadmill Exercise Training Improve Walking Distance in Peripheral Arterial Disease (PAD) Patients with Claudication
Introduction: Treadmill training is well recognized as an effective therapy to improve onset of claudication distance (OCD) and maximal walking distance (MWD) in patients with PAD, presumably through local adaptation of skeletal muscle. Preliminary studies show that aerobic arm exercise also improves MWD and OCD by unknown mechanisms. This is the first study to compare arm ergometry and treadmill training on walking ability in patients with PAD. This randomized controlled trial compared the effectiveness of arm ergometry and treadmill training, alone or in combination, versus controls in OCD and MWD in patients with claudication. We hypothesized that both methods would improve walking distance.
Methods: Participants (25m, 10f, mean age 67yrs, 87% smoking history, 27% with diabetes) with lifestyle limiting claudication were randomized to 12 weeks, 3h/week of one of 3 supervised progressive exercise groups (treadmill, arm ergometry or combination) or a control group. OCD and MWD were assessed via graded symptom-limited treadmill tests. Due to data variability, logarithmic transformations of baseline and 12 week OCD and MWD were performed. Group differences were assessed with ANCOVA using baseline OCD and MWD as covariates.
Results: Groups did not differ in baseline demographic, medical or exercise testing variables. Baseline and 12 week OCD and MWD values are presented in Table 1⇓. ANCOVA of MWD showed overall significance. Post hoc analyses demonstrated no differences between exercise groups in MWD, there were significant differences between all exercise groups versus controls. ANCOVA of OCD did not reach significance (p=.1).
Conclusions: This study suggests that aerobic arm and treadmill exercise improve MWD in patients with claudication. For those with severe disease, arm exercise appears to be a promising alternative. Studies with larger samples are needed to confirm results, elucidate mechanisms of improvement and establish optimal training regimen.