Impacts of aquatic walking on arterial stiffness, exercise tolerance, and physical function in patients with peripheral artery disease: a randomized clinical trial

2019 ◽  
Vol 127 (4) ◽  
pp. 940-949 ◽  
Author(s):  
Song-Young Park ◽  
Yi-Sub Kwak ◽  
Elizabeth J. Pekas
Keyword(s):  
Body Composition ◽  
Exercise Training ◽  
Arterial Stiffness ◽  
Physical Function ◽  
Peripheral Artery Disease ◽  
Exercise Tolerance ◽  
Muscular Strength ◽  
Peripheral Artery ◽  
Walking Exercise ◽  
Artery Disease

Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with attenuated vascular function, cardiorespiratory capacity, physical function, and muscular strength. It is essential to combat these negative effects on health by incorporating lifestyle interventions to slow disease progression, such as exercise. We sought to examine the effects of aquatic walking exercise on cardiovascular function, cardiorespiratory capacity [maximal volume of oxygen consumption (V̇o2max)], exercise tolerance [6-min walking distance (6MWD)], physical function, muscular strength, and body composition in patients with PAD. Patients with PAD ( n = 72) were recruited and randomly assigned to a 12-wk aquatic walking training group (AQ, n = 35) or a control group (CON, n = 37). The AQ group performed walking and leg exercises in waist-to-chest-deep water. Leg arterial stiffness [femoral-to-ankle pulse wave velocity (legPWV)], heart rate (HR), blood pressure (BP), ankle-to-brachial index (ABI), V̇o2max, 6MWD, physical function, muscular strength, body composition, resting metabolic rate (RMR), and flexibility were measured before and after 12 wk. There were significant group × time interactions ( P < 0.05) after 12 wk for legPWV and HR, which significantly decreased ( P < 0.05) in AQ, and V̇o2max, 6MWD, physical function, and muscular strength, which significantly increased ( P < 0.05) in AQ, compared with no changes in CON. There were no significant differences ( P > 0.05) for BP, ABI, RMR, or flexibility after 12 wk. Interestingly, there was relatively high adherence (84%) to the aquatic walking exercise program in this population. These results suggest that aquatic walking exercise is an effective therapy to reduce arterial stiffness and resting HR and improve cardiorespiratory capacity, exercise tolerance, physical function, and muscular strength in patients with PAD.NEW & NOTEWORTHY The results of this study reveal for the first time that aquatic walking exercise can decrease arterial stiffness and improve exercise tolerance, cardiorespiratory capacity, and muscular strength in patients with peripheral artery disease (PAD). Aquatic walking exercise training demonstrates relatively high exercise adherence in this population. Aquatic walking exercise training may be a useful therapeutic intervention for improving physical function in patients with PAD.

Effects of heated water-based versus land-based exercise training on vascular function in individuals with peripheral artery disease

2020 ◽  
Vol 128 (3) ◽  
pp. 565-575 ◽  
Author(s):  
Song-Young Park ◽  
Alexei Wong ◽  
Won-Mok Son ◽  
Elizabeth J. Pekas
Keyword(s):  
Body Composition ◽  
Peripheral Artery Disease ◽  
Exercise Therapy ◽  
Vascular Function ◽  
Exercise Tolerance ◽  
Peripheral Artery ◽  
Heated Water ◽  
Water Exercise ◽  
Artery Disease

Peripheral artery disease (PAD) is an atherosclerotic disease that is associated with poor vascular function, walking impairment, and reduced quality of life. Land-based exercise therapy (LBET) is frequently recommended to improve walking and reduce symptoms. Recently, evidence has suggested that heated-water exercise therapy (HWET) is an effective intervention for PAD. However, the efficacy of LBET versus HWET in PAD patients had not been elucidated. Therefore, we sought to compare effects of LBET with HWET on cardiovascular function, exercise tolerance, physical function, and body composition in PAD patients. PAD patients ( n = 53) were recruited and randomly assigned to a LBET group ( n = 25) or HWET group ( n = 28). The LBET group performed treadmill walking, whereas the HWET group performed walking in heated water for 12 wk. Leg (legPWV) and brachial-to-ankle arterial stiffness (baPWV), blood pressure (BP), ankle-brachial index (ABI), 6-min walking distance (6MWD), claudication onset time (COT), physical function, and body composition were assessed before and after 12 wk. There were significant group-by-time interactions ( P < 0.05) for legPWV, BP, 6MWD, COT, body composition, and resting metabolic rate (RMR). Both groups significantly reduced ( P < 0.05) legPWV, BP, and body fat percentage, and HWET measures were significantly lower than LBET measures. Both groups significantly increased 6MWD, COT, and RMR, and HWET group measures were significantly greater than LBET measures. A time effect was noted for baPWV reduction in both groups ( P < 0.05). These results suggest that both LBET and HWET improve cardiovascular function, exercise tolerance, and body composition, and HWET showed considerably greater improvements compared with LBET in patients with PAD. NEW & NOTEWORTHY The results of this study reveal for the first time that although land-based exercise therapy is effective for reducing arterial stiffness and blood pressure in patients with peripheral artery disease (PAD), heated-water exercise therapy demonstrates greater benefits on vascular function. The greater improvements in muscular strength, time to onset of claudication, and exercise tolerance after heated-water exercise therapy may have clinical implications for improving quality of life in patients with PAD. The heated-water exercise therapy intervention demonstrated relatively higher exercise training adherence (∼88%) compared with the land-based exercise intervention (∼81%).

scholarly journals Exercise Training and Revascularization in the Management of Symptomatic Peripheral Artery Disease

2021 ◽  
Vol 6 (2) ◽  
pp. 174-188
Author(s):  
Minakshi Biswas ◽  
Warren H. Capell ◽  
Mary M. McDermott ◽  
Donald L. Jacobs ◽  
Joshua A. Beckman ◽  
...  
Keyword(s):  
Exercise Training ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals Leg heat therapy improves perceived physical function but does not enhance walking capacity or vascular function in patients with peripheral artery disease

2020 ◽  
Vol 129 (6) ◽  
pp. 1279-1289
Author(s):  
Jacob C. Monroe ◽  
Chen Lin ◽  
Susan M. Perkins ◽  
Yan Han ◽  
Brett J. Wong ◽  
...  
Keyword(s):  
Physical Function ◽  
Peripheral Artery Disease ◽  
Vascular Function ◽  
Controlled Study ◽  
Peripheral Artery ◽  
Walking Capacity ◽  
Heat Therapy ◽  
Walking Performance ◽  
Artery Disease ◽  
Potent Vasoconstrictor

This is the first sham-controlled study to investigate the effects of leg heat therapy (HT) on walking performance, vascular function, and quality of life in patients with peripheral artery disease (PAD). Adherence to HT was high, and the treatment was well tolerated. Our findings revealed that HT applied with water-circulating trousers evokes a clinically meaningful increase in perceived physical function and reduces the serum concentration of the potent vasoconstrictor endothelin-1 in patients with PAD.

Endovascular treatment of peripheral artery disease is associated with improved central hemodynamics and ventricular function

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Messiha ◽  
L Halfmann ◽  
O Azizy ◽  
M Steinmetz ◽  
T Rassaf ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Left Ventricular Function ◽  
Endovascular Treatment ◽  
Ventricular Function ◽  
Peripheral Artery Disease ◽  
Cardiovascular Mortality ◽  
Left Ventricular ◽  
Central Hemodynamics ◽  
Peripheral Artery ◽  
Artery Disease

Abstract Background Peripheral artery disease (PAD) is a major manifestation of atherosclerosis and a risk factor for morbidity and mortality. PAD itself is associated with increased arterial stiffness with impact on cardiac functions. Previous studies have demonstrated that augmentation index (AIx) and central blood pressure (CBP) correlate with increased cardiovascular mortality. This mechanism has been described as arterio-ventricular (AV) coupling with altered ventricular afterload and a depressed ventricular function, measured by global longitudinal strain (GLS). The impact of PAD-related endovascular treatment on arterial stiffness, central hemodynamics and potential impact on AV coupling has not been elucidated until now. Purpose Aim of the study was to investigate, if endovascular treatment of PAD improves cardiac function via enhanced central hemodynamics and AV coupling. Methods To this aim 77 patients with known symptomatic PAD who underwent interventions in the iliac and femoropopliteal arteries were included in a cross-sectional study. AIx, CBP and GLS were determined using dedicated waveform analysis and echocardiography before and after endovascular treatment. Results Mean age was 65.1±10.4 years with 66.2% male patients. Symptoms were classified by Fontaine classification (stage IIb 80.7%, stage III 5.8% and stage IV 13.5%). Iliac vessel intervention was performed in 16 and femoropopliteal intervention in 61 cases. A stentless approach was feasible in 55 patients with DCB treatment and atherectomy. After endovascular treatment, peripheral perfusion was enhanced (ABI 0.45±0.6 vs 0.81±0.5, p&lt;0.0001). Moreover, central hemodynamics were improved (AIX 33.7±3% vs 27.9±2%, p=0.0008; AP 17.8±2 mmHg vs 14.0±2 mmHg, p=0.0004; central PP 52.4±6 mmHg vs 46.4±6 mmHg, p=0.0001). Impressively, left ventricular function was also significantly improved (GLS −15.7±2.3% vs −17.1±2.8%, p=0.005) with an improvement in AV coupling (PWV/GLS ratio −0.58m/sec% vs −0.56m/sec%, p&lt;0.01). Conclusion Our results demonstrate that endovascular treatment of the peripheral vessels is associated with an improvement of central hemodynamics and left ventricular function via enhanced AV coupling. These prognostic relevant markers of cardiovascular disease could point to an overall potential mortality benefit through PAD treatment. Further investigation of the underlying mechanisms of AV coupling in the setting of endovascular treatment of PAD with impact on cardiovascular mortality is needed in this high-risk population. Funding Acknowledgement Type of funding source: None

scholarly journals Community-based walking exercise for peripheral artery disease: An exploratory pilot study

2015 ◽  
Vol 20 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Ryan J Mays ◽  
William R Hiatt ◽  
Ivan P Casserly ◽  
R Kevin Rogers ◽  
Deborah S Main ◽  
...  
Keyword(s):  
Pilot Study ◽  
Peripheral Artery Disease ◽  
Peripheral Artery ◽  
Community Based ◽  
Walking Exercise ◽  
Artery Disease
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