Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication

• Published in: International journal of cardiology Vol. 168; no. 2; pp. 838 - 842
• Main Authors: Mika, Piotr, Konik, Anita, Januszek, Rafal, Petriczek, Tomasz, Mika, Anna, Nowobilski, Roman, Nizankowski, Rafal, Szczeklik, Andrzej
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 30.09.2013; Elsevier
• Subjects: Aged; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity - physiology; Cardiology. Vascular system; Cardiovascular; Claudication; Endothelial function; Endothelium, Vascular - physiology; Exercise Test - methods; Female; Heart; Humans; Intermittent Claudication - physiopathology; Intermittent Claudication - therapy; Male; Medical sciences; Middle Aged; Public health. Hygiene; Public health. Hygiene-occupational medicine; Teaching. Deontology. Ethics. Legislation; Treadmill training; Treatment Outcome; Vasodilation - physiology; Walking - physiology; Claudication; Endothelial function; Treadmill training; Atherosclerosis; Ability; Physical exercise; Cardiovascular disease; Teaching; Vascular disease; Locomotion; Walking; Intermittent; Cardiology; Comparative study; Occupational training; Life style
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2012.10.003

Abstract 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.