Effects of walking and strength training on walking capacity in individuals with claudication: meta-analysis

Alessandra De Souza Miranda,Diego Giulliano Destro Christofaro,Crivaldo Gomes Cardoso Junior,Maryela Oliveira Menacho,Lausanne Barreto De Carvalho Cahu Rodrigues,Sergio Luiz Cahu Rodrigues,Raphael Mendes Ritti-Dias

doi:10.1590/s1677-54492013000200004

Alessandra De Souza Miranda, Diego Giulliano Destro Christofaro + Show 5 more

Open Access

https://doi.org/10.1590/s1677-54492013000200004

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Abstract

CONTEXT: Over the past few years, several clinical trials have been performed to analyze the effects of exercise training on walking ability in patients with intermittent claudication (IC). However, it remains unclear which type of physical exercise provides the maximum benefits in terms of walking ability. OBJECTIVE: To analyze, by means of a meta-analysis, the effects of walking and strength training on the walking capacity in patients with IC. METHODS: Papers analyzing the effects of walking and strength training programs in patients with IC were browsed on the Medline, Lilacs, and Cochrane databases. Randomized clinical trials scoring >4 on the Physiotherapy Evidence Database (PEDro) scale and assessing claudication distance (CD) and total walking distance (TWD) were included in the review. RESULTS: Walking and strength training yielded increases in CD and TWD (P < 0.05). However, walking training yielded greater increases than strength training (P = 0.02). CONCLUSION: Walking and strength training improve walking capacity in patients with IC. However, greater improvements in TWD are obtained with walking training.

Highlights

Peripheral artery disease (PAD), one of the main atherosclerotic diseases, is associated with high morbidity rates among the elderly[1]
All individuals included in the study had mild to moderate intermittent claudication (IC), and mean ankle-brachial index (ABI) was 0.64 ± 0.06
Effects of training on walking ability The comparison of the effects of walking training and control intervention on claudication distance (CD) (Table 3) revealed that only walking training significantly increased CD (152 m; 95% claudicação intermitente (CI) [135, 168], P < 0.00001)

Summary

Introduction

Peripheral artery disease (PAD), one of the main atherosclerotic diseases, is associated with high morbidity rates among the elderly[1]. The main symptom of PAD is intermittent claudication (IC), characterized by pain in the lower limbs, the calf, when walking[2]. IC is the cause of limitations to walking, which may compromise the performance of physical activities of daily living[5]. Individuals with IC have muscle atrophy and decreased muscle strength[6], power and resistance in the lower limbs[7]. Supervised physical training combined with changes in life style has proven to be important interventions for the treatment of individuals with IC8, and significant increases in their walking ability and muscle and skeletal aptitudes have been found[9,10]

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