scholarly journals The Impact of Walking Exercises and Resistance Training upon the Walking Distance in Patients with Chronic Lower Limb Ischaemia

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Maria Szymczak ◽  
Grzegorz Oszkinis ◽  
Marian Majchrzycki
Keyword(s):  
Resistance Training ◽  
Intermittent Claudication ◽  
Rehabilitation Program ◽  
Lower Limbs ◽  
Walking Distance ◽  
Group Training ◽  
Limb Ischaemia ◽  
Walking Test ◽  
Resistance Exercises ◽  
The Impact

Objective. The objective of this paper is to compare the impact of supervised walking and resistance training upon the walking distance in PAD patients. Materials and Methods. The examination involved 50 PAD patients at the 2nd stage of the disease according to Fontaine’s scale. The participants were randomly allocated to two groups: one exercising on the treadmill (n=24) and one performing resistance exercises of lower limbs (n=26). Results. The 12-week program of supervised rehabilitation led to a significant increase in the intermittent claudication distance measured both on the treadmill and during the 6-minute walking test. The group training on the treadmill showed a statistically significant increase of the initial claudication distance (ICD) and the absolute claudication distance (ACD) measured on the treadmill, as well as of ICD and the total walking distance (TWD) measured during the 6-minute walking test. Within the group performing resistance exercises, a statistically significant improvement was observed in the case of parameters measured on the treadmill: ICD and ACD. Conclusions. The supervised rehabilitation program, in the form of both walking and resistance exercises, contributes to the increase in the intermittent claudication distance. The results obtained in both groups were similar.

scholarly journals Cross-sectoral rehabilitation intervention for patients with intermittent claudication versus usual care for patients in non-operative management - The CIPIC Rehab study: study protocol for a randomised controlled trial

2019 ◽  
Author(s):  
Maj Siercke ◽  
Lise Pyndt Jørgensen ◽  
Malene Missel ◽  
Lau Caspar Thygesen ◽  
Pernille Peppercorn Blach ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Usual Care ◽  
Intermittent Claudication ◽  
Mixed Method ◽  
Operative Management ◽  
Treadmill Walking ◽  
Rehabilitation Programme ◽  
Walking Distance ◽  
Walking Test ◽  
Non Operative Management

Abstract Introduction: Intermittent claudication (IC) caused by Peripheral Artery Disease (PAD) is a common cardiovascular disease. Patients with IC have reduced walking capacity, restricted activity levels and mobility, and reduced health-related quality of life. The disease leads to social isolation, the risk of cardiovascular morbidity, and mortality. Non-operative management of IC requires exercise therapy and studies show that supervised exercise training is more effective than unsupervised training, yet many patients with IC lack motivation for changes in health behavior. No studies investigating the effects of existing cardiac rehabilitation targeted patients with IC have been published. The aim of this paper is to present the rationale and design of the CIPIC Rehab Study, which examines the effect of a cross-sectoral rehabilitation programme versus usual care for patients in non-operative management for IC. Methods and analysis: A randomised clinical trial aims to investigate whether cardiac rehabilitation for patients with IC in non-operative management versus usual care is superior to treatment as usual. The trial will allocate 118 patients, 1:1 individual randomisation to either the intervention or control group. The primary outcome is maximal walking distance measured by the standardised treadmill walking test. The secondary outcome is pain-free walking distance measured by the standardised treadmill walking test, healthy diet measured by a fat-fish-fruit-green score, and level of physical activity measured by activity score within official recommendations. Statistical analyses will be blinded. Several exploratory analyses will be performed. A mixed-method design is used to evaluate qualitative and quantitative findings. A qualitative and a survey-based complementary study will be undertaken to investigate patients’ post-discharge experiences. A qualitative post-intervention study will explore experiences of participation in rehabilitation. Discussion: The study is the first to assess the effect of a cardiac rehabilitation programme designed for patients with intermittent claudication. The study will describe how to monitor and improve rehabilitations programme for patients with intermittent claudication in a real-world setting. Mixed method strategies can allow for both exploration and generalization in the same study, but the research design is a complex intervention and any effects found can not be awarded a specific component.

The test to retest reproducibility of walking test for intermittent claudication associated with lumbar spinal stenosis

2020 ◽  
Author(s):  
Shinji Tanishima ◽  
Hu Jianzhong ◽  
Zhao Jie ◽  
Yang Huilin ◽  
Hideki Nagashima ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Lower Limb ◽  
Cauda Equina ◽  
Walking Distance ◽  
Walking Test ◽  
Lower Limb Pain ◽  
Significant Difference ◽  
Lumbar Spinal

Abstract Background The walking test is useful to evaluate leg numbness and pain caused by cauda equina symptoms in patients with lumbar spinal stenosis but there are few reports described about reproducibility. The study aim was to evaluate the reproducibility of the walking test for lumbar spinal stenosis Methods Seventy patients with lumbar spinal stenosis who had intermittent claudication symptoms at a multicenter outpatient clinic were examined prospectively. A walking test was performed at 0 and 4 weeks. We investigated walking distance and lower limb pain and numbness in this study. Pain and numbness were evaluated by using the Visual Analog Scale (VAS) immediately after the walking test for the hip and outside, inside, front, and posterior sides of the lower legs. Cohen’s kappa analysis and interphase correlation coefficients (ICCs) were used to evaluate reproducibility. The Swiss Spinal Stenosis Questionnaire (SSS) was used to evaluate stenosis severity. Results The mean SSS was 30.2 ± 5.5 initially and 29.2 ± 5.2 at week 4, with no significant difference in severity ( P = 0.10). The walking distance ICC between baseline and 4 weeks was 0.670. The interobserver reliabilities for lower limb ache and numbness in both legs were acceptable. The average VAS for lower leg pain was 23.2 ± 25.2 mm at baseline and 27.4 ± 28.8 mm at week 4. The ICC was 0.668. The average VAS for leg numbness was 23.4 ± 26.7 mm at baseline and 24.8 ± 25.2 mm at week 4. The ICC was 0.683. Conclusions The walking test walking distance and symptomatic site results were reproducible.

scholarly journals Influence of Mild Peripheral Arterial Obstructive Disease in the Functional Capacity

2019 ◽  
Vol 21 (3) ◽  
pp. 225
Author(s):  
Eduardo Brandão Azevedo ◽  
Keila De Castro Marinho Azevedo ◽  
Inácio Teixeira da Cunha Filho ◽  
Rodrigo Nicolato
Keyword(s):  
Physical Fitness ◽  
Intermittent Claudication ◽  
Functional Capacity ◽  
Lower Limbs ◽  
Control Group ◽  
Obstructive Disease ◽  
Significant Difference ◽  
Peripheral Arterial Obstructive Disease ◽  
Peripheral Arterial ◽  
The Impact

AbstractThe peripheral arterial obstructive disease (PAOD) is a chronic illnes that has as main symptom intermittent claudication and causes a progressive functional impairment of the patient. The literature is still inconclusive when it addresses the relationship among functional capacity, endurance, muscle contraction speed, and degree of blood flow impairment in patients with PAOD. The objective of this study was to evaluate the physical fitness individuals with bilateral PAOD, claudication and ankle-brachial index between 0.8 and 0.9, to verify the impact of the disease in this outcome and to analyze the association among the tests. Forty individuals, with mean age 56 years were divided in: group PAOD (n=20) and control group (n=20) were subjected to the following tests: Five-Times-Sit-to-Stand Test (FTSST), Heel-rise test (HRT), test of gait speed usual (UV) and maximum (MV), shuttle walking test (SWT). There was a significant difference among the variables obtained through HRT, UV, MV and SWT, showing a worse performance of the group with PAOD compared to the control. The FTSST test showed no differences among the groups. Analyzing the whole sample, the presence of PAOD is an indicator of poor performance in TDBP. This study suggests that people with mild PAOD present reduced performance in functional endurance tests of the lower limbs and that there is a direct relationship between walking speed and patency of local arterial flow, demonstrating in an unprecedented way the need for evaluation of this public, considering the possibility of initial identification of the symptoms and giving greater efficiency in the therapeutic planning of maintenance of the functionality.Keywords: Physical Fitness. Intermittent Claudication. Peripheral Vascular Diseases.ResumoA doença arterial obstrutiva periférica (DAOP) é uma doença crônica que tem como sintoma principal a claudicação intermitente e causa um progressivo comprometimento funcional do paciente. A literatura ainda é inconclusiva quando aborda a relação entre a capacidade funcional, endurance, velocidade de contração muscular e grau de comprometimento de fluxo sanguíneo em pacientes com DAOP. O objetivo deste estudo foi avaliar a aptidão física de indivíduos com DAOP bilateral, claudicantes e Índice tornozelo-braço entre 0,8 e 0,9, verificar o impacto da doença neste desfecho e analisar a associação entre os testes. Quarenta indivíduos, com faixa etária média de 56 anos, divididos em grupo DAOP (n=20) e grupo controle (n=20), foram submetidos aos testes: Teste senta-levanta (TSL), teste ponta de pé (TPP), testes de velocidade usual (VU) e máxima (VM), teste de deslocamento bidirecional progressivo (TDBP). Houve diferença significativa entre as variáveis do TPP, VU, VM e TDBP, mostrando pior performance do grupo com DAOP comparado ao controle. O teste TSL não apresentou diferença entre os grupos. Analisando os grupos em conjunto a presença de DAOP foi indicadora de pior desempenho no TDBP. Este estudo sugere que pacientes com DAOP leve apresentam redução da performance nos testes funcionais de endurance dos membros inferiores e que existe uma relação direta entre a velocidade da marcha e a patência do fluxo arterial local, demonstrando de forma inédita, a necessidade de avaliação deste público, considerando a possibilidade de identificação inicial dos sintomas e conferindo maior eficiência no planejamento terapêutico de manutenção da funcionalidade.Palavras-chave: Aptidão Física. Claudicação Intermitente. Doenças Vasculares Periféricas.

scholarly journals A cilostazol hatékony és biztonságos lehetőség a claudicatio intermittens kezelésére. A NOCLAUD vizsgálat eredményei

2017 ◽  
Vol 158 (4) ◽  
pp. 123-128 ◽  
Author(s):  
Katalin Farkas ◽  
Zoltán Járai ◽  
Endre Kolossváry
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Adverse Events ◽  
Intermittent Claudication ◽  
Walking Distance ◽  
Claudicatio Intermittens ◽  
Efficacy And Safety ◽  
Walking Test ◽  
Efficacy Analysis

Abstract: Intermittent claudication can seriously impair the patients’ quality of life. Cilostazol was registered in Hungary in 2014. This study aimed to evaluate the efficacy and safety of cilostazol in patients with intermittent claudication. 1405 patients were enrolled to the 6 months, multicenter, non-interventional trial. From the 1331 patients, who completed the study, the data of 674 patients were subjected to efficacy analysis. Pain free and maximal walking distance and the 6 minute walking test improved significantly at 3 months (78.65%, 65.23%, 56.09%; respectively, p<0.001), and a further increase was observed after 6 months treatment (129.74%, 107.2, 80.38% respectively, p<0.001). Adverse events occured in 7.26% of the patients. The most frequent adverse events were headache, diarrhea, dizziness, tachycardia or palpitation. 24 patients (1.7%) stopped cilostazol treatment because of side effects. 6 month cilostazol treatment significantly increased the walking distance in patients with intermittent claudication, without important safety problems. Orv. Hetil., 2017, 158(4), 123–128.

scholarly journals Programmed body weight loss in morbidly obese women and its influence on general physical fitness, knee status and every day life activity

2016 ◽  
Vol 126 (2) ◽  
pp. 88-90
Author(s):  
Iwona Morawik ◽  
Aneta Zarębska ◽  
Marian Jędrych ◽  
Michał Zajko ◽  
Mirosław Jabłoński
Keyword(s):  
Body Weight ◽  
Weight Reduction ◽  
Well Being ◽  
Lower Limbs ◽  
Knee Joints ◽  
Walking Distance ◽  
Morbidly Obese ◽  
Obese Women ◽  
Obese People ◽  
The Impact

Abstract Introduction. Obesity is a serious health and social problem. Various sources indicate that it affects approx. 20% of the world’s population. It is also counted among the diseases of affluence. Excessive body weight adversely affects a number of systems in the human body, including the locomotor system. Studies have shown that there is a close relationship between obesity and either a dysfunction or osteoarthritis of knee joints. Aim. To evaluate the impact of weight reduction on the basic parameters of the overall capacity of obese women and their well-being. Material and methods. 7 extremely obese women aged 28-51 looking to reduce their body weight participated in the study. The weight reduction program lasted for 12 months and consisted of reported intervention. The validated survey by Johanson was used to assess the performance of the lower limbs. Each tested person filled in 3 surveys of the same kind – the first at the beginning of the research project, the second after losing 20 kg of body weight, and the third after 12 months of weight reduction. Results. There has been a statistically significant decrease in body weight (p=0.002) and BMI (p=0.002) of women surveyed between the specific periods of observation. The pain from the knee joints decreased or was resolved through weight reduction (p=0.004) in the respondents. The participants also started to take less painkillers for knee discomfort (p=0.005). Authors also noted an increase of the walking distance without rest (p=0.01) and less problems while walking upstairs (p=0.004). There was a statistically significant improvement in their self-care for the feet (p=0.003), as well as in the ability to use public transport (p=0.05) or to do shopping (p=0.05). There were no significant differences in the performance of household chores, getting out of bed, using the bath or shower or in need of orthopaedic equipment. Conclusions. Significant weight reduction in obese women proportionally reduces or relieves knee pain and improves their performance. It reduces the need for using analgesics. Weight reduction in obese people has a significant impact on improving the performance of lower limbs.

Antithrombotic Drugs in the Primary Medical Management of Intermittent Claudication: A Meta-analysis

1999 ◽  
Vol 81 (05) ◽  
pp. 715-722 ◽  
Author(s):  
Enrico Bernardi ◽  
Martin Prins ◽  
Jan Wouter ten Cate ◽  
Paolo Prandoni ◽  
Rohan Hettiarachchi ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Odds Ratio ◽  
Ankle Brachial Index ◽  
Lower Limbs ◽  
Walking Distance ◽  
Antithrombotic Drugs ◽  
Vascular Events ◽  
Manual Search ◽  
Level 1 ◽  
Revascularization Procedures

Summary Background. There is no consensus on the efficacy of the antithrombotic drugs available for patients with intermittent claudication. Methods. A Medline and manual search was used to identify relevant publications. Uncontrolled or retrospective studies, double reports or trials without clinical outcomes were excluded. Included studies were graded as level 1 (randomised and double- or assessor-blind), level 2 (open randomised), or level 3 (non-randomised comparative). Mortality, cerebro- or cardiovascular events, amputations, arterial occlusions or number of revascularization procedures performed in the lower limbs, pain-free and total walking distance, ankle brachial index and calf blood flow, were the main outcomes considered. When feasible, end of treatment results, either continuous or binary, were combined with appropriate statistical methods. Results. Mortality was significantly decreased by ticlopidine compared to placebo (common odds ratio 0.68, 95% C.I., 0.49 - 0.95); clopidogrel decreased vascular events in comparison to aspirin (odds ratio 0.76, 95% C.I., 0.63 - 0.92) in level 1 studies. Arterial occlusions and the number of revascularization procedures performed were statistically significantly decreased by aspirin and ticlopidine, respectively. A small but statistically significant improvement in pain-free walking distance was determined by picotamide, indobufen, low molecular weight heparins, sulodexide and defibrotide, in small studies. Conclusions. Clopidogrel and ticlopidine do reduce clinically important events in patients with intermittent claudication and could be added to the primary medical treatment of these patients. The use of aspirin in these patients cannot be based on direct evidence, but only on analogy with coronary and cerebral atherosclerosis, where it has documented efficacy. Other antithrombotic drugs were not properly evaluated in patients with intermittent claudication.

scholarly journals Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners

2020 ◽  
Vol 6 (1) ◽  
pp. e000897
Author(s):  
Amy E Harwood ◽  
Sean Pymer ◽  
Lee Ingle ◽  
Patrick Doherty ◽  
Ian C Chetter ◽  
...  
Keyword(s):  
Exercise Training ◽  
Intermittent Claudication ◽  
Mode Of Delivery ◽  
Lower Limbs ◽  
Walking Distance ◽  
Walking Ability ◽  
Aerobic Activity ◽  
Supervised Exercise ◽  
Home Based ◽  
Exercise Programmes

Peripheral artery disease (PAD) is caused by atherosclerotic narrowing of the arteries supplying the lower limbs often resulting in intermittent claudication, evident as pain or cramping while walking. Supervised exercise training elicits clinically meaningful benefits in walking ability and quality of life. Walking is the modality of exercise with the strongest evidence and is recommended in several national and international guidelines. Alternate forms of exercise such as upper- or lower-body cycling may be used, if required by certain patients, although there is less evidence for these types of programmes. The evidence for progressive resistance training is growing and patients can also engage in strength-based training alongside a walking programme. For those unable to attend a supervised class (strongest evidence), home-based or ‘self-facilitated’ exercise programmes are known to improve walking distance when compared to simple advice. All exercise programmes, independent of the mode of delivery, should be progressive and individually prescribed where possible, considering disease severity, comorbidities and initial exercise capacity. All patients should aim to accumulate at least 30 min of aerobic activity, at least three times a week, for at least 3 months, ideally in the form of walking exercise to near-maximal claudication pain.

scholarly journals Elastic Tubing Resistance Training and Autonomic Modulation in Subjects with Chronic Obstructive Pulmonary Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Ana Laura Ricci-Vitor ◽  
Luiz Carlos M. Vanderlei ◽  
Carlos Marcelo Pastre ◽  
Dionei Ramos ◽  
Ercy Mara C. Ramos ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Resistance Training ◽  
Pulmonary Disease ◽  
Autonomic Dysfunction ◽  
Walking Distance ◽  
Shoulder Abduction ◽  
Chronic Obstructive ◽  
Autonomic Modulation ◽  
Obstructive Pulmonary Disease ◽  
Walking Test

This study addresses evidence concerning elastic tubing resistance training (ET) on autonomic modulation in patients with chronic obstructive pulmonary disease (COPD). Autonomic dysfunction is common in COPD and contributes to the development of arrhythmias and sudden death. Along with autonomic dysfunction, muscle dysfunction is related to functional limitations and prognosis of the disease. This study investigated the effects of ET on autonomic modulation, muscle strength, and walking distance in COPD. Subjects were divided into two groups, ET (n=20; 66,5±8,9 y; 25,5±3,5 kg/m2; FEV1/FVC: 50,3±11,0) and conventional training (n=19; 66,0±6,9; 27,1±4,3; FEV1/FVC: 55,05±9,56). Both groups undertook 24 sessions for 60 minutes, 3 times in a week. The significance level was p ≤ 0,05. Autonomic modulation was evaluated using heart rate variability in the time (rMSSD, ms) and frequency domain (HF, ms). Strength for upper and lower limbs was measured using dynamometry and walking distance was measured using a 6-minute walking test. There were no significant differences in the outcomes between groups. There was an increment to rMSSD [(16,7±11,0 versus 20,8±14,9) versus (14,2±10,0 versus 17,4±12,1)], HF [(141,9±191,3 versus 234,9±335,7) versus (94,1±123,5 versus 177,6±275,5)], shoulder abduction [(50,1±19,6 versus 56,9±20,4) versus (50,5±19,0 versus 56,9±19,3)], knee flexion [(101,9±34,0 versus 116,8±43,3) versus (98,6±21,5 versus 115,1±30,8)], and walking test [(433,0±84,8 versus 468,9±90,8) versus (397,4±99,8 versus 426,3±101,6)] after training for ET and conventional training, respectively. In conclusion, ET improves autonomic modulation in COPD with additional benefits for strength and cardiorespiratory capacity similar to conventional training.

scholarly journals EFFECT OF 16 WEEKS OF RESISTANCE TRAINING ON STRENGTH ENDURANCE IN MEN AND WOMEN

2019 ◽  
Vol 25 (5) ◽  
pp. 399-403
Author(s):  
Letícia Trindade Cyrino ◽  
Edilson Serpeloni Cyrino ◽  
Evelyn Caroline de Araujo e Silva ◽  
Ademar Avelar ◽  
Michele Caroline de Costa Trindade ◽  
...  
Keyword(s):  
Resistance Training ◽  
Bench Press ◽  
Lower Limbs ◽  
Behavioral Differences ◽  
Treatment Results ◽  
Level Of Evidence ◽  
Men And Women ◽  
Second Stage ◽  
Therapeutic Study ◽  
The Impact

ABSTRACT Introduction Although resistance training (RT) can provide numerous benefits for both men and women, morphological, neuromuscular, metabolic, physiological, and behavioral differences between sexes may influence the magnitude of training responses. Objective To analyze the impact of 16 weeks of progressive RT on strength endurance in untrained men and women. Methods Twenty-eight men and 31 women (18-30 years) underwent a supervised RT program that was divided into two 8-week stages, 3 times per week on nonconsecutive days. The RT program was composed of exercises for different body segments (trunk, upper and lower limbs) that were performed with three sets of 8-12 repetitions maximum (RM), in 10 and 12 exercises, in the first and second stage, respectively. Strength endurance was assessed in 3 exercises (bench press, squat, and arm curl) and in a combination of these exercises through a protocol composed of 4 sets performed to failure with 80% of 1-RM on the baseline, after 8 and 16 weeks of RT. Results Group vs. time interactions (p <0.05) were found for bench press (men = +28.3% vs. women = +32.1%), squat (men = +13.5% vs. women = +32.7%), and arm curl (men = +20.2% vs. women = +24.4%) exercises, as well as in the set of all 3 exercises (men = +18.4% vs. women = +31.2%). Conclusion Our results suggest that 16 weeks of RT can improve strength endurance in both men and women, although higher gains are achieved by women. Level of evidence II; Therapeutic study-Investigating treatment results.

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