Journal of Vascular Surgery
Volume 42, Issue 4 , Pages 702-709, October 2005

The effect of exercise intensity on the response to exercise rehabilitation in patients with intermittent claudication

Presented at the International Society of Cardiovascular Surgery Meeting, Waimea, Hawaii, March 22-25, 2004.

  • Andrew W. Gardner, PhD

      Affiliations

    • CMRI Metabolic Research Center, University of Oklahoma Health Sciences Center
    • Department of Medicine, Division of Gerontology, University of Maryland
    • Corresponding Author InformationReprint requests: Andrew W. Gardner, PhD, Hobbs-Recknagel Professor, CMRI Metabolic Research Center, University of Oklahoma Health Sciences Center, 1122 N.E. 13th Street, ORI-W 1400, Oklahoma City, OK 73117.
    • ,
  • Polly S. Montgomery, MS

      Affiliations

    • CMRI Metabolic Research Center, University of Oklahoma Health Sciences Center
    • Department of Medicine, Division of Gerontology, University of Maryland
    • ,
  • William R. Flinn, MD

      Affiliations

    • Department of Surgery, Division of Vascular Surgery, University of Maryland
    • ,
  • Leslie I. Katzel, MD, PhD

      Affiliations

    • Department of Medicine, Division of Gerontology, University of Maryland
    • Maryland Veterans Affairs Health Care System.

Received 2 April 2005; accepted 30 May 2005.

Purpose

The purpose of this randomized trial was to compare the efficacy of a low-intensity exercise rehabilitation program vs a high-intensity program in changing physical function, peripheral circulation, and health-related quality of life in peripheral arterial disease (PAD) patients limited by intermittent claudication.

Methods

Thirty-one patients randomized to low-intensity exercise rehabilitation and 33 patients randomized to high-intensity exercise rehabilitation completed the study. The 6-month exercise rehabilitation programs consisted of intermittent treadmill walking to near maximal claudication pain 3 days per week at either 40% (low-intensity group) or 80% (high-intensity group) of maximal exercise capacity. Total work performed in the two training regimens was similar by having the patients in the low-intensity group exercise for a longer duration than patients in the high-intensity group. Measurements of physical function, peripheral circulation, and health-related quality of life were obtained on each patient before and after the rehabilitation programs.

Results

After the exercise rehabilitation programs, patients in the two groups had similar improvements in these measures. Initial claudication distance increased by 109% in the low-intensity group (P < .01) and by 109% in the high-intensity group (P < .01), and absolute claudication distance increased by 61% (P < 0.01) and 63% (P < .01) in the low-intensity and high-intensity groups, respectively. Furthermore, both exercise programs elicited improvements (P < .05) in peak oxygen uptake, ischemic window, and health-related quality of life.

Conclusion

The efficacy of low-intensity exercise rehabilitation is similar to high-intensity rehabilitation in improving markers of functional independence in PAD patients limited by intermittent claudication, provided that a few additional minutes of walking is accomplished to elicit a similar volume of exercise.

 

 Competition of interest: none.Supported by grants from the National Institute on Aging (NIA) (R01-AG-16685, K01-00657; A. W. G.), by a Claude D. Pepper Older American Independence Center grant from NIA (P60-AG12583), by a Geriatric, Research, Education, and Clinical Center grant from the Veterans Affairs Administration, and by a National Institutes of Health, National Center for Research Resources, General Clinical Research Center grant (M01-RR-14467).

PII: S0741-5214(05)00919-5

doi:10.1016/j.jvs.2005.05.049

Journal of Vascular Surgery
Volume 42, Issue 4 , Pages 702-709, October 2005

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