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Vol 23, No 1 (2017)
Review paper
Published online: 2017-05-12

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Applied methods of exercise based therapy for the extension of walking distance in patients with intermittent claudication

Wojciech Pasiak, Anna Stelmach, Agnieszka Zdzienicka- Chyla, Marek Banbula, Tomasz Zubilewicz
Acta Angiologica 2017;23(1):25-28.

Abstract

Intermittent claudication, according to the Fontaine Classification Scale is a symptom of 2nd degree atherosclerosis of the arteries of the lower limbs. The process of atherosclerosis involves increased narrowing of the blood vessel lumina and their eventual closure. Patients with atherosclerosis often suffer bouts of muscular pain while walking which eventually leads to restricted mobility. The treatment of those affected by furring up of the arteries of the lower limbs includes intravascular procedures, insertion of balloon devices and stents and in severe cases of atherosclerosis surgical intervention is required. The more conservative areas of treatment involve pharmacotherapy, patient participation in educational training sessions, lifestyle changes and appropriate physiotherapy referrals. If applied early on, lifestyle changes such as smoking cessation, an improved diet, as well as targeted training can help avoid the need for surgical intervention. At the moment, the goal of mainstream physiotherapy in the treatment of peripheral artery disease is to determine the most appropriate forms of exercise which can increase the walking distance of patients with intermittent claudication, improve blood-flow in particular to the lower extremities as well as improve patients’ overall quality of life. The purpose of this study is to gather and analyse exercise strategies that result in increased walking distance in intermittent claudication. The best results have been observed in groups who teamed up ambulatory therapy with strength training; Nordic walking therapy along with strength training and finally walking training with upper body aerobic training on the cross-trainer. The variety of training combinations gives us the ability to cater for and accommodate individual patient needs.

References

  1. Konik A, Mika P, Nowobilski R, et al. Mechanizm responsible for reducing intermittent claudication as a result of treadmill training . Acta Angio. 2010; 16: 49–66.
  2. Bulińska K, Kropielnicka K, Jasiński T, et al. Skórkowska – Telichowska K, Pilch K Kompleksowa rehabilitacja pacjentów z chromaniem przestankowym w przewlekłym niedokrwieniu kończyn dolnych. Fizjoterapia. 2012; 4: 3–16.
  3. Tendera M, et al. Wytyczne dotyczące rozpoznania i leczenia chorób tętnic obwodowych. Kardiol Pol. 2011; 69: 271–340.
  4. Norgen L, Hiatt WR, Dormandy JA, et al. on behalf of the TASC II Working Group Inter society consensus for the management of peripheral arteria disease. (TASC II). Eur J Vasc Endovasc Surg. 2007; 33: 1–70.
  5. Szymczak M, Majchrzycki M, Stryła W, et al. The effects of various form of rehabilitation on patients with lower limb ischemia. Trends in Sport. 2014; 2: 93–100.
  6. Melton C. Supervised exercise program helps patiens with peripheral artery disease walk longer. Clinical Geriatrics. 2011; 19: 1–17.
  7. Fokkenrood HJP, Bendermacher BLW, Lauret GJ, et al. Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication. Cochrane Database Syst Rev. 2006(2): CD005263.
  8. Crowther RG, Leicht AS, Spinks WL, et al. Effects of a 6-month exercise program pilot study on walking economy, peak physiological characteristics, and walking performance in patients with peripheral arterial disease. Vasc Health Risk Manag. 2012; 8: 225–232.
  9. McDermott MM, Liu K, Guralnik JM, et al. Home-based walking exercise intervention in peripheral artery disease: a randomized clinical trial. JAMA. 2013; 310(1): 57–65.
  10. Guidon M, McGee H. One-year effect of a supervised exercise programme on functional capacity and quality of life in peripheral arterial disease. Disabil Rehabil. 2013; 35(5): 397–404.
  11. Leicht AS, Crowther RG, Golledge J. Influence of peripheral arterial disease and supervised walking on heart rate variability. J Vasc Surg. 2011; 54(5): 1352–1359.
  12. Dopheide JF, Rubrech J, Trumpp A, et al. Supervised exercise training in peripheral arterial disease increases vascular shear stress and profunda femoral artery diameter. Eur J Prev Cardiol. 2017; 24(2): 178–191.
  13. Thiede R, Toosizadeh N, Mills JL, et al. Gait and balance assessments as early indicators of frailty in patients with known peripheral artery disease. Clin Biomech (Bristol, Avon). 2016; 32: 1–7.
  14. Celis R, Pipinos II, Scott-Pandorf MM, et al. Peripheral arterial disease affects kinematics during walking. J Vasc Surg. 2009; 49(1): 127–132.
  15. Wang E, Helgerud J, Loe H, et al. Maximal strength training improves walking performance in peripheral arterial disease patients. Scand J Med Sci Sports. 2010; 20(5): 764–770.
  16. Grizzo Cucato G, de Moraes Forjaz CL, Kanegusuku H, et al. Effects of walking and strength training on resting and exercise cardiovascular responses in patients with intermittent claudication. Vasa. 2011; 40(5): 390–397.
  17. Kropielniecka K. Kropielniecka K Wpływ wybranych form treningowych na czynność mięśni kończyn dolnych I tolerancję wysiłku u pacjentów z chromaniem przestankowym. Praca doktorska. 2013.
  18. Szymczak M, Oszkinis G, Majchrzycki M. The Impact of Walking Exercises and Resistance Training upon the Walking Distance in Patients with Chronic Lower Limb Ischaemia. Biomed Res Int. 2016; 2016: 7515238.
  19. Collins EG, McBurney C, Butler J, et al. The Effects of Walking or Walking-with-Poles Training on Tissue Oxygenation in Patients with Peripheral Arterial Disease. Int J Vasc Med. 2012; 2012: 985025.
  20. Collins EG, Oʼconnell S, McBurney C, et al. Comparison of walking with poles and traditional walking for peripheral arterial disease rehabilitation. J Cardiopulm Rehabil Prev. 2012; 32(4): 210–218.
  21. Kowalski R. Porównanie efektów treningu na biezni ruchomej z treningiem na cykloergometrze rowerowym u pacjentów z miażdżycą tętnic dolnych. Praca doktorska. 2007.
  22. Dedes H, Figoni S, Kalioundji G, et al. Poster 42: Prospective Trial of Calf Ergometry Training on Walking Ability in Peripheral Arterial Disease. PM&R. 2010; 2(9): S26.
  23. Kowalski R, Jasiak-Tyrkalska B, Brzostek T, et al. Porównanie efektu na bieżni ruchomej z treningiem na cykloergometrze rowerowym – doniesienia wstępne. Fizjoterapia Polska. 2007; 7: 438–436.
  24. Bronas UG, Treat-Jacobson D, Leon AS. Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication. J Vasc Surg. 2011; 53(6): 1557–1564.
  25. Treat-Jacobson D, Bronas UG, Leon AS. Efficacy of arm-ergometry versus treadmill exercise training to improve walking distance in patients with claudication. Vasc Med. 2009; 14(3): 203–213.
  26. Treat – Ja, Bronas UG, Krause BJ, et al. erobic arm exercise training to improve outcomes for patients with severe claudication and ischemic rest pain. Vascular Medicine. 2012; 17: 204.
  27. Walker RD, Nawaz S, Wilkinson CH, et al. Influence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication. J Vasc Surg. 2000; 31(4): 662–669.