A W Gardner1, J S Skinner, C X Bryant, L K Smith. 1. Geriatric Research, Education and Clinical Center, Baltimore Veterans Affairs Medical Center, MD 21201-1524, USA.
Abstract
PURPOSE: Peripheral arterial disease patients limited by claudication pain frequently have concomitant-cardiovascular problems during exercise, such as hypertension and myocardial ischemia. Thus, for testing and rehabilitation purposes, exercise which elicits lower heart rate and blood pressure at a given metabolic intensity would be preferred over a more demanding task. The purpose of this study was to compare the cardiovascular responses of claudication patients during walking and stair climbing at a similar level of oxygen uptake. METHODS: Ten patients limited by claudication pain performed treadmill walking and stair climbing tests. RESULTS: Oxygen uptake was similar (P > .05) during walking and stair climbing (13.7 vs. 13.5 mL/kg/min, respectively). The times to onset and to maximal claudication pain, as well as the peripheral hemodynamic measurements of ankle systolic pressure, ankle-to-brachial systolic pressure index, and foot transcutaneous oxygen tension were also similar between the two tests (P > .05). However, heart rate, systolic pressure, diastolic pressure, mean arterial pressure, and rate-pressure product values were lower during and following stair climbing than compared to walking (P < .05). CONCLUSION: Stair climbing may offer an advantage over treadmill walking for claudication patients because similar metabolic, claudication, and peripheral hemodynamic measurements are obtained with concomitantly less demand placed on the cardiovascular system. The stair climbing test was well tolerated and safely performed by each patient.
PURPOSE: Peripheral arterial diseasepatients limited by claudication pain frequently have concomitant-cardiovascular problems during exercise, such as hypertension and myocardial ischemia. Thus, for testing and rehabilitation purposes, exercise which elicits lower heart rate and blood pressure at a given metabolic intensity would be preferred over a more demanding task. The purpose of this study was to compare the cardiovascular responses of claudicationpatients during walking and stair climbing at a similar level of oxygen uptake. METHODS: Ten patients limited by claudication pain performed treadmill walking and stair climbing tests. RESULTS:Oxygen uptake was similar (P > .05) during walking and stair climbing (13.7 vs. 13.5 mL/kg/min, respectively). The times to onset and to maximal claudication pain, as well as the peripheral hemodynamic measurements of ankle systolic pressure, ankle-to-brachial systolic pressure index, and foot transcutaneous oxygen tension were also similar between the two tests (P > .05). However, heart rate, systolic pressure, diastolic pressure, mean arterial pressure, and rate-pressure product values were lower during and following stair climbing than compared to walking (P < .05). CONCLUSION: Stair climbing may offer an advantage over treadmill walking for claudicationpatients because similar metabolic, claudication, and peripheral hemodynamic measurements are obtained with concomitantly less demand placed on the cardiovascular system. The stair climbing test was well tolerated and safely performed by each patient.
Authors: Molly N Schieber; Iraklis I Pipinos; Jason M Johanning; George P Casale; Mark A Williams; Holly K DeSpiegelaere; Benjamin Senderling; Sara A Myers Journal: J Vasc Surg Date: 2019-08-20 Impact factor: 4.268