Influence of upper and lower limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication

Richard D. Walker, Shah Nawaz, Claire H. Wilkinson, John M. Saxton, A. Graham Pockley, Richard F. M. Wood

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103 Citations (Scopus)

Abstract

Purpose: The effects of upper-limb (arm cranking) and lower-limb (leg cranking) exercise training on walking distances in patients with intermittent claudication was assessed. Methods: Sixty-seven patients (33 to 82 years old) with moderate to severe intermittent claudication were recruited, and the maximum power generated during incremental upper- and lower-limb ergometry tests was determined, as were pain-free and maximum walking distances (by using a shuttle walk test). Patients were randomly assigned to an upper-limb training group (n = 26) or a lower-limb training group (n = 26). An additional untrained group (n = 15) was recruited on an ad hoc basis in parallel with the main trial by using identical inclusion criteria. This group was subsequently shown to possess a similar demographic distribution to the two exercise groups. Supervised training sessions were held twice weekly for 6 weeks. Results: Both training programs significantly improved the maximum power generated during the incremental upper- and lower-limb ergometry tests (P <.001), which may reflect an increase in central cardiovascular function that was independent of the training mode. More importantly, pain-free and maximum walking distances also improved in both training groups (P <.001). The improvements in the training groups were similar; there were no changes in the untrained control group. These findings suggest that the symptomatic improvement after upper-limb exercise training may result, in part, from systemic cardiovascular effects rather than localized metabolic or hemodynamic changes. Conclusion: Carefully prescribed upper-limb exercise training can evoke a rapid symptomatic improvement in patients with claudication, while avoiding the physical discomfort experienced when performing lower-limb weight-bearing exercise.
Original languageEnglish
Pages (from-to)662-669
Number of pages8
JournalJournal of Vascular Surgery
Volume31
Issue number4
DOIs
Publication statusPublished - 2000

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