BACKGROUND: In this randomized trial we compared two treadmill trainings, based on exercises performed to moderate claudication pain vs pain-free training, with respect to their effects on walking ability and endothelial function. METHODS: A total of sixty patients with stable intermittent claudication were randomized to the pain-free treadmill training (repetitive intervals to onset of claudication pain) or moderate treadmill training (repetitive intervals to moderate claudication pain). In both groups exercises were performed 3 times a week for 3 months. Changes in flow mediated dilatation (FMD) and treadmill walking performance as well as plasma levels of C-reactive protein (hs-CRP) and fibrinogen were assessed before and after the program. RESULTS: Fifty-two patients completed the training program. Post-training maximal walking time was prolonged by 100% (p<0.001) vs 98% (p<0.001), and pain-free walking time by 120% (p<0.001) vs 93% (p<0.001) in the moderate training group as compared to the pain-free training group, respectively. FMD increased by 56% (p<0.001) in the moderate training group and by 36% (p<0.01) in the pain-free training group. No significant changes in the levels of hs-CRP and fibrinogen were seen after treadmill program in either group. CONCLUSIONS: Both pain-free treadmill training and the moderate treadmill training have similar efficacy on walking ability in patients with claudication. The improvement of post-training FMD indicates systemic effect of both treadmill programs on endothelial function. Both programs appear to be safe therapeutic modes, since none of them escalates the inflammation. Pain-free treadmill training seems useful and effective therapeutic option for patients with claudication.
RCT Entities:
BACKGROUND: In this randomized trial we compared two treadmill trainings, based on exercises performed to moderate claudication pain vs pain-free training, with respect to their effects on walking ability and endothelial function. METHODS: A total of sixty patients with stable intermittent claudication were randomized to the pain-free treadmill training (repetitive intervals to onset of claudication pain) or moderate treadmill training (repetitive intervals to moderate claudication pain). In both groups exercises were performed 3 times a week for 3 months. Changes in flow mediated dilatation (FMD) and treadmill walking performance as well as plasma levels of C-reactive protein (hs-CRP) and fibrinogen were assessed before and after the program. RESULTS: Fifty-two patients completed the training program. Post-training maximal walking time was prolonged by 100% (p<0.001) vs 98% (p<0.001), and pain-free walking time by 120% (p<0.001) vs 93% (p<0.001) in the moderate training group as compared to the pain-free training group, respectively. FMD increased by 56% (p<0.001) in the moderate training group and by 36% (p<0.01) in the pain-free training group. No significant changes in the levels of hs-CRP and fibrinogen were seen after treadmill program in either group. CONCLUSIONS: Both pain-free treadmill training and the moderate treadmill training have similar efficacy on walking ability in patients with claudication. The improvement of post-training FMD indicates systemic effect of both treadmill programs on endothelial function. Both programs appear to be safe therapeutic modes, since none of them escalates the inflammation. Pain-free treadmill training seems useful and effective therapeutic option for patients with claudication.
Authors: Marie D Gerhard-Herman; Heather L Gornik; Coletta Barrett; Neal R Barshes; Matthew A Corriere; Douglas E Drachman; Lee A Fleisher; Francis Gerry R Fowkes; Naomi M Hamburg; Scott Kinlay; Robert Lookstein; Sanjay Misra; Leila Mureebe; Jeffrey W Olin; Rajan A G Patel; Judith G Regensteiner; Andres Schanzer; Mehdi H Shishehbor; Kerry J Stewart; Diane Treat-Jacobson; M Eileen Walsh Journal: Circulation Date: 2016-11-13 Impact factor: 29.690
Authors: David Hageman; Hugo Jp Fokkenrood; Lindy Nm Gommans; Marijn Ml van den Houten; Joep Aw Teijink Journal: Cochrane Database Syst Rev Date: 2018-04-06
Authors: Amy E Harwood; Sean Pymer; Lee Ingle; Patrick Doherty; Ian C Chetter; Belinda Parmenter; Christopher D Askew; Gary A Tew Journal: BMJ Open Sport Exerc Med Date: 2020-11-05
Authors: Michael M Hammond; Bonnie Spring; W Jack Rejeski; Robert Sufit; Michael H Criqui; Lu Tian; Lihui Zhao; Shujun Xu; Melina R Kibbe; Christiaan Leeuwenburgh; Todd Manini; Daniel E Forman; Diane Treat-Jacobson; Tamar S Polonsky; Lydia Bazzano; Luigi Ferrucci; Jack Guralnik; Donald M Lloyd-Jones; Mary M McDermott Journal: J Am Heart Assoc Date: 2022-07-27 Impact factor: 6.106
Authors: Stefan T Birkett; Jonathan Sinclair; Sally A Seed; Sean Pymer; Edward Caldow; Lee Ingle; Amy E Harwood; Anselm Egun Journal: Ther Adv Cardiovasc Dis Date: 2022 Jan-Dec