scholarly journals Micro-Lightguide Spectrophotometry (O2C) for Lower Limb Perfusion: Effects of Exercise Walking in Claudicants

2019 ◽  
Vol 28 (03) ◽  
pp. 161-166
Author(s):  
Thomas Gyldenløve ◽  
Lise P. Jørgensen ◽  
Torben V. Schroeder
Keyword(s):  
Oxygen Saturation ◽  
Intermittent Claudication ◽  
Ankle Brachial Index ◽  
Exercise Program ◽  
Arterial Disease ◽  
Treadmill Test ◽  
Home Based ◽  
Walking Capacity ◽  
Treadmill Testing ◽  
Peripheral Arterial

Background Exercise walking has improved walking capacity in patients with intermittent claudication without affecting the macrocirculation reflected in ankle pressures. We wanted to investigate microcirculation in the skin related to exercise walking by using Micro-Lightguide Spectrophotometry (O2C). Materials and Methods Twenty-eight patients with intermittent claudication—bilateral in 17—were included in a 12 weeks of structured home-based exercise program. The pain-free and maximal walking distances were determined on a treadmill. Saturation and flow, monitored by O2C, were examined immediately before and after the treadmill test. O2C examination took place before as well as after completion of the exercise program. Ankle–brachial index was obtained before treadmill testing. Results As expected, walking performance improved significantly without affecting ankle pressures. Neither oxygen saturation nor flow, assessed at 2 mm depth, was affected following a 12 weeks of exercise program. We observed a significant decrease in oxygen saturation and flow upon treadmill testing in the both limbs in patients with bilateral peripheral arterial disease (PAD). In contrast, the treadmill test elicited no changes in the opposite and asymptomatic limb in patients with only unilateral PAD. Conclusion The findings suggest that O2C may be used to study microcirculatory changes. However, it is best suited for the study of phenomena resulting in major changes as it eliminates some inherent variability.

scholarly journals The effects of exercise training on muscle oxygenation of patients with intermittent claudication

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
P Chatzinikolaou ◽  
N Cornelis ◽  
J Claes ◽  
R Buys ◽  
I Fourneau ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Near Infrared ◽  
Saturation Index ◽  
Ankle Brachial Index ◽  
Muscle Oxygenation ◽  
Lower Limbs ◽  
Current Evidence ◽  
Test Time ◽  
Treadmill Test ◽  
Walking Capacity

Abstract Funding Acknowledgements Type of funding sources: None. Background. Intermittent claudication (IC) is characterized by a cramp-like pain during walking caused by insufficient blood flow to the lower limbs during exercise. The walking impairment caused by IC can lead to a vicious cycle of physical inactivity, decreased quality of life and progression of cardiovascular risk factors. Although current evidence supports the benefits of walking training to increase walking capacity, little is known about its effect on muscle oxygenation in this population. Purpose. The aim of this study was to investigate the effects of a hybrid 12-week walking program (combined center- and home-based walking) on muscle oxygenation of IC patients. Methods. Thirty-seven patients with IC were enrolled of which 33 completed follow-up measurements (age 71 ± 9 yrs, body mass index 26 ± 4 kg/m2, ankle brachial index (ABI) 0.7 ± 0.2) after the 12-week intervention. Outcome measures were pain-free walking capacity (PFWC), maximal walking capacity (MWC) and calf muscle oxygenation, respectively evaluated using a submaximal treadmill test, a Gardner treadmill test and near-infrared spectroscopy (NIRS). Results. After the 12-week intervention, significantly higher values (reported as median and interquartiles) for PFWC (162 m [122, 217] to 272 m [150, 401]; p < 0.001) and MWC (458 m [260, 638] to 611 m [333, 840]; p < 0.001) were observed. As shown in Table 1, NIRS data measured during the submaximal walking test showed an increased availability of oxygenated hemoglobin (p = 0.048) and decreased deoxyhemoglobin (p = 0.013), while total hemoglobin remained unchanged after the 12-week intervention. During the Gardner test, time to reach minimum tissue saturation index (TSI%) increased (p < 0.001), yet no change was noted on minimum TSI during exercise, despite increased MWC. Despite a trend towards faster recovery times, no significant changes were observed after the 12-week intervention. Conclusion. Hybrid walking exercise therapy improves deoxygenation kinetics and walking capacity in IC patients. Increased availability of oxygenated hemoglobin might underly the improvement in walking capacity.

Effects of structured home-based exercise training on circulating endothelial progenitor cells and endothelial function in patients with intermittent claudication

2021 ◽  
pp. 1358863X2110208
Author(s):  
Leonella Pasqualini ◽  
Francesco Bagaglia ◽  
Stefano Ministrini ◽  
Maria Rosaria Frangione ◽  
Christian Leli ◽  
...  
Keyword(s):  
Exercise Training ◽  
Endothelial Function ◽  
Training Program ◽  
Progenitor Cells ◽  
Intermittent Claudication ◽  
Treadmill Test ◽  
Home Based ◽  
Exercise Training Program ◽  
Walking Capacity ◽  
Walking Time

Introduction: Exercise training improves walking capacity in patients with intermittent claudication (IC). Endothelial progenitor cells (EPCs), endothelial microparticles (EMPs), and endothelial dysfunction could play a role in this process. Methods: We measured EPCs and EMPs in a group of 60 patients with IC, and in a control group of 20 individuals without IC, before a treadmill test and 2, 24, and 48 hours after the test. Thirty patients with IC were randomly assigned to perform a 12-week home-based exercise training program. The EPC count, flow-mediated dilation (FMD) of the brachial artery, pain-free walking time (PFWT), and maximum walking time (MWT) were measured at the baseline and after the exercise training program. Results: In patients with IC, EMPs significantly increased 2 hours after the treadmill test, whereas EPCs significantly increased after 24 hours. Among the subjects assigned to complete the training program, we observed a significant increase in the number of EPCs after 12 weeks, as well as an improvement in FMD, PFWT, and MWT. A significant correlation between the variation of EPCs, FMD, and MWT was found. The increase of EPCs and FMD were independent determinants of the walking capacity improvement, without significant interaction. Conclusion: Our results suggest that EPCs mobilization contributes to the improvement of walking capacity in patients with IC undergoing structured physical training. A number of different, partly independent, mechanisms are involved in this process, and our results highlight the potential role of EMPs release and endothelial function improvement. ClinicalTrials.gov Identifier: NCT04302571

scholarly journals Drug-coated balloons used in peripheral artery disease: experience from a single center

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094015
Author(s):  
Jinbo Liu ◽  
Tianrun Li ◽  
Wei Huang ◽  
Na Zhao ◽  
Huan Liu ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Single Center ◽  
Single Center Study ◽  
Before And After ◽  
Artery Disease ◽  
Peripheral Arterial

Objective This retrospective single-center study aimed to analyze immediate and follow-up results of using drug-coated balloons (DCBs) for treating peripheral arterial disease. Methods In this study, we identified a total of 75 patients who underwent DCB therapy at our institution. The ankle–brachial index (ABI) was measured before and after intervention. Intermittent claudication and whether there was healing of ulcers were determined by telephone. Results The cohort consisted of 56 men and 19 women aged 38 to 87 years (68 ± 12 years). Twenty-three patients had Rutherford grade III, 15 had Rutherford grade IV, and 37 had Rutherford grade V. Seventeen patients had stents and 18 had the Rotarex system used. The postoperative ABI was significantly greater than the preoperative ABI (0.911 ± 0.173 vs 0.686 ± 0.249). Good results for treatment were obtained. Intermittent claudication and rest pain did not occur in subjects with Rutherford grades III and IV during follow-up. The amputation rate was 4.1% among all patients using DCB therapy during follow-up. Conclusions DCB therapy is safe and effective for treating peripheral arterial disease in real-world patients. Future prospective studies on this issue are recommended.

scholarly journals The prevalence of peripheral arterial disease in diabetic subjects in south-west Nigeria

2012 ◽  
Vol 4 (1) ◽  
Author(s):  
Bolaji O. Oyelade ◽  
Akintayo D. OlaOlorun ◽  
Louis O. Odeigah ◽  
Isaac O. Amole ◽  
Olufemi S. Adediran
Keyword(s):  
Peripheral Arterial Disease ◽  
Intermittent Claudication ◽  
Objective Assessment ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Cross Sectional ◽  
Index Measurement ◽  
Clinical Methods ◽  
History Of ◽  
Peripheral Arterial

Background: Peripheral arterial disease (PAD) is rarely sought for and generally underdiagnosed even in diabetics in developing countries like Nigeria. PAD is easily detected and diagnosed by the ankle-brachial index, a simple and reliable test. Objectives: To determine the prevalence of PAD in diabetic subjects aged 50–89 years and the value of ankle-brachial index measurement in the detection of PAD.Method: A cross-sectional descriptive study of 219 diabetic subjects aged 50–89 years was carried out. The participants were administered a pre-tested questionnaire and measurement of ankle-brachial index (ABI) was done. The ankle-brachial index < 0.90 was considered equivalent to peripheral arterial disease.Results: The overall prevalence of PAD was 52.5%. The prevalence of symptomatic PAD was 28.7% whilst that of asymptomatic PAD was 71.3%. There were a number of associations with PAD which included, age (p < 0.05), sex (p < 0.05), and marital status (p < 0.05). The use of the ankle-brachial index in the detection of PAD was clearly more reliable than the clinical methods like history of intermittent claudication and absence or presence of pedal pulses.Conclusion: The prevalence of PAD is relatively high in diabetic subjects in the southwestern region of Nigeria. Notable is the fact that a higher proportion was asymptomatic. Also the use of ABI is of great value in the detection of PAD as evidenced by a clearly more objective assessment of PAD compared to both intermittent claudication and absent pedal pulses.

Effect of Supervised Exercise Program on Individuals in Peripheral Arterial Disease with Type 2 Diabetes Mellitus - A Systematic Review

2020 ◽  
Vol 16 (3) ◽  
pp. 248-253
Author(s):  
Esha Arora ◽  
Arun G. Maiya ◽  
Tom Devasia ◽  
Rama Bhat ◽  
Ganesh Kamath
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Ankle Brachial Index ◽  
Exercise Program ◽  
Arterial Disease ◽  
Supervised Exercise ◽  
Peripheral Arterial ◽  
Supervised Exercise Program

Background: Type 2 Diabetes Mellitus (T2DM) is usually accompanied by various micro and macro vascular complications. Peripheral Arterial Disease (PAD) is one of the major complications of diabetes which is accountable for morbidity and mortality throughout the world. The first line of treatment in these individuals is life style modification and exercise. There is a dearth of literature on effect of supervised exercise program in PAD with T2DM on quality of life, walking impairment, change in Ankle Brachial Index (ABI) values. So, we conducted a systematic review to explore the available literature on supervised exercise program in PAD with T2DM. Methods: We conducted a systematic review (PubMed, Web of Science, CINAHL and Cochrane) to summarise the evidence on a supervised exercise program in PAD with T2DM. Randomised and nonrandomised studies were included in the review. Results: Three studies met the inclusion criteria. The outcomes taken into accounts by the studies were the quality of life, walking impairment questionnaire, Ankle brachial index. Neither of the studies matched in their supervised exercise program nor in their outcome. Conclusion: In conclusion, the data evaluating the supervised exercise program in PAD with T2DM is inadequate to determine its effect on this population. Future large-scale studies can be conducted on both subjective and objective outcomes of PAD with T2DM to have a better understanding of the condition and for a universally acceptable exercise program for these individuals which the healthcare practitioners can use in their practice.

scholarly journals Rationale and design of a smartphone‐enabled , home‐based exercise program in patients with symptomatic peripheral arterial disease: The smart step randomized trial

2020 ◽  
Vol 43 (6) ◽  
pp. 537-545
Author(s):  
Arash Harzand ◽  
Alexander A. Vakili ◽  
Alaaeddin Alrohaibani ◽  
Smah M. Abdelhamid ◽  
Neil F. Gordon ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Randomized Trial ◽  
Exercise Program ◽  
Arterial Disease ◽  
Home Based ◽  
Peripheral Arterial

Use of the walking impairment questionnaire as a measure of functional assessment

VASA ◽  
2021 ◽  
pp. 1-8
Author(s):  
Pavel Poredos ◽  
Urska Zlajpah ◽  
Peter Poredos ◽  
Ana Spirkoska Mangaroska ◽  
Mateja K. Jezovnik
Keyword(s):  
Intermittent Claudication ◽  
Functional Capacity ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Self Report ◽  
Walk Test ◽  
Peripheral Arterial ◽  
6 Minute Walk Test ◽  
Minute Walk ◽  
Walk Tests

Summary: Background: A significant consequence of peripheral arterial disease (PAD) is an impaired functional capacity and deteriorated quality of life. Therefore, our study aimed to investigate the usefulness of a symptom questionnaire and walk tests for the determination of the functional capacity of patients with intermittent claudication. Patients and methods: The study included 53 patients (38 males) with stable claudication distance (50–300m). A detailed history and physical examination, ankle-brachial index (ABI), treadmill exercise test, and 6-minute walk test were performed and compared to walking impairment questionnaire (WIQ). Results: Claudication distance reported from patients’ history and 6-minute walk test were significantly correlated with ABI (p=0.033, p=0.044). There were no significant correlations between ABI and treadmill walk test or WIQ. Results of WIQ were significantly correlated with the history and the most of performed walk tests: treadmill initial and maximal claudication distance (p=0.004 and 0.012, respectively) and 6-minute walk test (p=0.026). 6-minute walk test was correlated with maximal claudication distance of treadmill (p=0.018), but not with an initial claudication distance. Conclusions: The validity of WIQ is comparable to walk tests and represents the useful technique for the investigation of the functional capacity of patients with PAD. A self-report based on WIQ enables a longer period of observation. It should be routinely used as a basic diagnostic tool for the estimation of the functional capacity of PAD patients with stable intermittent claudication.

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