Abstract
Peripheral arterial occlusive disease (PAOD) limits walking efficiency and distance. The main disabling symptom is vasculopathy that leads to claudicatio intermittens and limits walking efficiency. Stretching techniques are effective in treatments for retractions and are used to improve flexibility of triceps surae and range of motion of the ankle. The aim of this study is to evaluate the effects of a combined walking and stretching program on walking efficiency in elderly PAOD patients. Seventy patients with PAOD stage II of the Leriche–Fontaine classification were randomly assigned into a stretching group (SG) or conditioning group (CG). Both groups participated in an eleven-day intensive rehabilitation program based on walking and strength training, while the SG performed five extra sessions of stretching. Walking autonomy was assessed through treadmill and overground tests with the recording of initial and absolute pain. A univariate ANOVA analysis was applied for the differences between the initial and final outcomes. Walking autonomy improved in both groups (p < 0.01), while only the SG improved flexibility (from −14.0 ± 8.1 to −10.3 ± 8.3 cm; p < 0.01). An intensive eleven-day rehabilitation program based on walking, strength, and stretching exercises is effective to improve the onset and the delay of pain during walking in patients with PAOD.
Highlights
Peripheral arterial occlusive disease (PAOD) is a syndrome that showsdifferent nosological symptoms due to the reduction of blood flow in the lower limbs district [1,2]
The aim of the present study is to evaluate the effects of a specific stretching program on walking performance in elderly PAOD patients
Seventy patients (14 females) with PAOD stage II of the Leriche–Fontaine classification [19] were freely recruited in hospital setting (Città di Pavia, Pavia, Italy) and were randomly divided into two groups: the stretching group (SG, n = 37) and the conditioning group (CG, n = 33)
Summary
Peripheral arterial occlusive disease (PAOD) is a syndrome that showsdifferent nosological symptoms due to the reduction of blood flow in the lower limbs district [1,2]. Clinical practice has suggested that a lot of patients suffer pain in the lumbar region associated with a retraction of the muscles [12] This framework is probably a driver toward claudication [13]: calf muscles stiffness reduces, for example, the ankle dorsal flexion and increases the risk of fall during the clearance of the feet [14]. From a functional point of view, improved flexibility in lower limbs and all its components (muscles, tendons, and joints) could generally improve the gait [15] In this view, a specific stretching training of lower limb muscles could positively affect the process of rehabilitation in PAOD patients. The aim of the present study is to evaluate the effects of a specific stretching program on walking performance in elderly PAOD patients
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