Abstract

Most men and women with lower extremity peripheral arterial disease (PAD) do not have classic symptoms of intermittent claudication (IC). We assessed the ability of supervised treadmill walking exercise and lower extremity resistance training to improve walking performance, quality of life, and brachial arterial flow-mediated dilation (FMD) in PAD persons with and without symptoms of IC. The study design was a randomized controlled clinical trial. One-hundred fifty participants with ankle brachial index (ABI) < 0.95 were randomized to one of three arms for 6 months: a) supervised treadmill exercise; b) supervised lower extremity resistance training; c) control condition. Outcomes were six-month change in the six-minute walk test, maximal treadmill walking performance, brachial arterial FMD, and the quality-of-life outcome measures of the Walking Impairment Questionnaire (WIQ) scores and the Short-Form 36 Physical Functioning score. The average age of study participants was 70.6 + 10.3, the average ABI was 0.60 + 0.20, and 52% were women. One hundred thirty-six (91%) participants completed follow-up. Results are shown in the Table . Findings were similar when analyses were restricted to participants without IC. This study demonstrates, for the first time, that both aerobic and resistance exercise interventions improve treadmill walking performance and WIQ scores in PAD persons with and without classic symptoms of IC. Supervised treadmill exercise additionally improves six-minute walk performance and brachial arterial FMD in PAD participants with and without IC. TABLE. Change in outcomes at six month follow-up by group assignment.

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