Abstract 20670: Investigating the Effect of Progressive Resistance Training on Walking Ability in Persons With Peripheral Arterial Disease: A Meta- Analysis
Introduction: Alternative modes of exercise have been shown to improve walking ability in persons with peripheral arterial disease (PAD). A small number of trials have reported progressive resistance training (PRT) improves walking ability in persons with PAD. In addition, associations between leg strength and walking distances have been reported, providing rationale for using PRT in this disease. However, there has been no synthesis of the literature to help clarify the role of PRT for this population to date. We conducted a meta-analysis of published randomised controlled trials (RCTs) using PRT as an intervention for persons with PAD, with walking ability as an outcome.
Methods: An electronic database search was conducted of Medline, Embase, Web of Science, Cinahl and Google Scholar up until 31st May 2016. RCTs investigating the effect of PRT on graded treadmill (GT) and/or 6-minute walk (6MW) distances were included. Mean differences (MD) were calculated using a random effects inverse variance model, and heterogeneity and bias were assessed using Revman 5.3.
Results: Seven RCTs including 387 patients (n=144 completing PRT), mean age 68.8±2.2 years were included. PRT programs ranged from low to high intensity; 2-3 times per week for 17±7weeks, with a mix of upper, lower or whole body training. Overall, PRT significantly improved GT pain-free distance MD 50.52m (0.92 to 100.11); p=0.05; and maximal walking distance MD 97.41m (47.96 to 146.85); p=0.0001. PRT 3 x week significantly improved 6MW pain-free distance MD 110.6m (49.71 to 171.49); p=0.0004 but not 6MW maximal distance. Moderate-high intensity PRT led to a larger improvement in GT maximal walking distance MD 106.75m (54.37 to 159.14); p<0.0001 when compared to low intensity. Training 3 x week also produced a larger improvement in GT maximal walking distance MD 103.43m (52.34 to 154.51); p<0.0001 when compared to twice weekly.
Conclusions: PRT significantly improves walking ability to a clinically relevant extent in persons with PAD, with better results related to higher intensity and volume of training. More trials are needed to investigate the effect of different training intensities, exercises and frequency of training, as well as to provide direct comparisons with other exercise modalities.
Author Disclosures: B. Parmenter: None. Y. Mavros: None. M. Fiatarone Singh: None.
- © 2016 by American Heart Association, Inc.