Baseline Predictors of Improved Walking During a Supervised Exercise Program in Men and Women With Peripheral Artery Disease

Abstract

PURPOSE: We compared the changes in ambulatory outcomes between men and women with symptomatic peripheral arterial disease (PAD) following completion of a supervised, on-site, treadmill exercise program, and we determined whether baseline clinical characteristics and exercise training variables were predictive of changes in the ambulatory outcomes in men and women. METHODS: Twenty-three men (ankle-brachial index = 0.66 ± 0.26) and 25 women (ankle-brachial index = 0.69 ± 0.24) completed the supervised exercise program, consisting of intermittent walking to mild-to-moderate claudication pain for three months. Ambulatory outcome measures were peak walking time (PWT) and claudication onset time (COT) during a treadmill test, and distance recorded during a 6-minute walk test (6MWD). RESULTS: Men and women had significant increases in the change in COT (p < 0.001 and p < 0.01, respectively), and in the change in PWT (p < 0.001 for each group). However, the change in PWT was significantly less in the women than in the men (p < 0.05). Neither group had a significant change in 6MWD. In women, baseline COT was the only predictor that entered the model for the change in COT (p = 0.007) and the change in PWT (p = 0.094). In men, baseline COT (p < 0.01) and obesity (p < 0.10) were the predictors that entered the model for the change in COT, and obesity was the only predictor that entered the model for the change in PWT (p = 0.002). CONCLUSIONS: We conclude that following a supervised, on-site, treadmill exercise program, women had less improvement in PWT than men, and neither men nor women improved submaximal, over-ground 6MWD. Furthermore, obese men and patients with lower baseline COT were least responsive to supervised exercise.