Mauer Karin, Exaire J Emilio, Stoner Julie A, Saucedo Jorge F, Montgomery Polly S, Gardner Andrew W
Reynolds Oklahoma Center on Aging, Donald W. Reynolds Department of Geriatric Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
Department of Cardiology, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA.
SAGE Open Med. 2015 Mar 19;3:2050312115575938. doi: 10.1177/2050312115575938. eCollection 2015.
Patients with peripheral artery disease have walking impairment, greater thrombotic risk, and are often treated with exercise training. We sought to determine the effect of a 3-month-long exercise program on clot strength among patients with peripheral artery disease and intermittent claudication.
Twenty-three symptomatic peripheral artery disease patients were randomly assigned to a walking exercise program or to an attention control group who performed light resistance exercise. We investigated the effect of exercise training on clot strength and time to clot formation was assessed by thromboelastography.
After 3 months of exercise, clot strength (maximal amplitude) and time to clot formation (R) did not change significantly from baseline, even after improvements in claudication onset time (p < 0.01) and peak walking time (p < 0.05). Furthermore, changes in clot formation parameters were not significantly different between groups. Among the 10 individuals demonstrating a reduction in clot strength (reduced maximal amplitude), one was a smoker (10%) compared to 9 of 13 non-responders (69%) whose maximal amplitude was unchanged or increased (p = 0.0097).
In this ancillary study, a 12-week walking program improved ambulatory function in peripheral artery disease patients with claudication, but does not modify clot strength or time to clot formation. Larger studies are needed to confirm these hypothesis generating findings and to determine whether a different amount or type of exercise may induce a change in clotting in this patient population.
外周动脉疾病患者存在行走障碍,血栓形成风险更高,且常接受运动训练治疗。我们试图确定一项为期3个月的运动计划对患有外周动脉疾病和间歇性跛行患者的血凝块强度的影响。
23名有症状的外周动脉疾病患者被随机分配到步行运动计划组或进行轻度抗阻运动的注意力控制组。我们通过血栓弹力图评估运动训练对血凝块强度的影响以及血凝块形成时间。
运动3个月后,即使跛行发作时间(p < 0.01)和峰值步行时间(p < 0.05)有所改善,血凝块强度(最大振幅)和血凝块形成时间(R)与基线相比无显著变化。此外,两组之间血凝块形成参数的变化无显著差异。在10名血凝块强度降低(最大振幅降低)的个体中,1名是吸烟者(10%),而在13名无反应者中有9名(69%),其最大振幅未改变或增加(p = 0.0097)。
在这项辅助研究中,一项为期12周的步行计划改善了患有间歇性跛行的外周动脉疾病患者的行走功能,但并未改变血凝块强度或血凝块形成时间。需要更大规模的研究来证实这些产生假设的发现,并确定不同运动量或运动类型是否可能导致该患者群体凝血发生变化。