BACKGROUND: Intermittent claudication (IC) is a common condition which is associated with significant quality of life limitation. National Institute for Health and Care Excellence guidelines recommend a group-based supervised exercise program as the primary treatment option for claudication, based on clinical and cost effectiveness. This review aims to assess the mechanisms by which exercise improves outcomes in patients with IC. METHODS: MEDLINE, EMBASE, and PubMed were searched using the search strategy "claudication" [AND] "exercise" [AND] "mechanisms." Searches were limited from 1947 to October 2014. Only full-text articles published in the English language in adults (over 18 years of age) were eligible for the review. Any trial involving a nonsupervised exercise program was excluded. Abstracts identified by the database search were interrogated for relevance and citations from the shortlisted papers were hand searched for relevant references. RESULTS: The search yielded a total of 112 studies, of which 42 were duplicates. Forty-seven of the remaining 70 were deemed appropriate for inclusion in the review. Exercise is the first-line treatment for IC. Supervised exercise programs improve walking distances, endothelial and mitochondrial function, muscle strength, and endurance. Furthermore, it leads to a generalized improvement in cardiovascular fitness and overall quality of life. CONCLUSIONS: The mechanism by which exercise improves outcome in claudicants is complicated and multifactorial. Further research is required in this area to fully elucidate the precise and predominant mechanisms and to assess whether targeted exercise program modification maximizes mechanism efficacy and patient outcome.
BACKGROUND:Intermittent claudication (IC) is a common condition which is associated with significant quality of life limitation. National Institute for Health and Care Excellence guidelines recommend a group-based supervised exercise program as the primary treatment option for claudication, based on clinical and cost effectiveness. This review aims to assess the mechanisms by which exercise improves outcomes in patients with IC. METHODS: MEDLINE, EMBASE, and PubMed were searched using the search strategy "claudication" [AND] "exercise" [AND] "mechanisms." Searches were limited from 1947 to October 2014. Only full-text articles published in the English language in adults (over 18 years of age) were eligible for the review. Any trial involving a nonsupervised exercise program was excluded. Abstracts identified by the database search were interrogated for relevance and citations from the shortlisted papers were hand searched for relevant references. RESULTS: The search yielded a total of 112 studies, of which 42 were duplicates. Forty-seven of the remaining 70 were deemed appropriate for inclusion in the review. Exercise is the first-line treatment for IC. Supervised exercise programs improve walking distances, endothelial and mitochondrial function, muscle strength, and endurance. Furthermore, it leads to a generalized improvement in cardiovascular fitness and overall quality of life. CONCLUSIONS: The mechanism by which exercise improves outcome in claudicants is complicated and multifactorial. Further research is required in this area to fully elucidate the precise and predominant mechanisms and to assess whether targeted exercise program modification maximizes mechanism efficacy and patient outcome.
Authors: Daniel E Forman; Ross Arena; Rebecca Boxer; Mary A Dolansky; Janice J Eng; Jerome L Fleg; Mark Haykowsky; Arshad Jahangir; Leonard A Kaminsky; Dalane W Kitzman; Eldrin F Lewis; Jonathan Myers; Gordon R Reeves; Win-Kuang Shen Journal: Circulation Date: 2017-03-23 Impact factor: 29.690
Authors: J Carter Luck; Amanda J Miller; Faisal Aziz; John F Radtka; David N Proctor; Urs A Leuenberger; Lawrence I Sinoway; Matthew D Muller Journal: J Appl Physiol (1985) Date: 2017-04-06
Authors: Erin K Englund; Michael C Langham; Felix W Wehrli; Molly J Fanning; Zeeshan Khan; Kathryn H Schmitz; Sarah J Ratcliffe; Thomas F Floyd; Emile R Mohler Journal: Am J Physiol Heart Circ Physiol Date: 2022-07-08 Impact factor: 5.125
Authors: Amy E Harwood; Christopher Ja Pugh; Charles J Steward; Campbell Menzies; C Doug Thake; Tom Cullen Journal: Vasc Med Date: 2021-02-15 Impact factor: 3.239
Authors: Zhe Li; Erin K Englund; Michael C Langham; Jinchao Feng; Kebin Jia; Thomas F Floyd; Arjun G Yodh; Wesley B Baker Journal: Metabolites Date: 2021-11-29