Department of Sports Science, Exercise and Health, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal; Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Vila Real, Portugal.
Angiology and Vascular Surgery Department, Trás-os-Montes and Alto Douro Hospital Center (CHTMAD), Vila Real, Portugal; Vascular Surgery Department, Senhora da Oliveira Hospital Center, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
J Vasc Nurs. 2024 Sep;42(3):145-153. doi: 10.1016/j.jvn.2024.03.002. Epub 2024 Apr 1.
Exercise therapy is a recognized non-pharmacological intervention for peripheral arterial disease (PAD); however, the effects of combined exercise remain under investigation. This study aimed to compare the effects of a 6-month combined supervised exercise program (SUP) with a usual care (UC) approach on walking ability, physical fitness, and peripheral blood flow in people with PAD and claudication.
Twenty-three male participants (Age=64.1 ± 6.2years and ABI=0.58±0.07) with PAD and claudication were assigned to either the SUP group (n = 10), engaging in structured supervised treadmill walking combined with three resistance exercises, three times a week, or the UC group (n = 13), receiving advice to walk. The primary outcome measure was walking ability, with assessments conducted at baseline (M0), after 3 months (M3), and 6 months (M6).
After the 6-month intervention, the SUP group exhibited significant improvements in absolute claudication time (ACT, p = 0.045), maximal walking time (MWT, p = 0.045), maximal walking distance (MWD, p = 0.027), and pause duration (p = 0.045) during the 6-minute walk test (6MWT), when compared to the UC group. Over time, a significant increase in walking speed during the 6MWT (Speed, p = 0.001) and walking speed without claudication (Speed, p < 0.001) was found, although no significant differences were found between the groups. The SUP group increased by 0.8 km/h in both Speed and Speed, while the UC group increased by 0.3 km/h and 0.6 km/h, respectively. Despite claudication consistently occurring at the same time, the SUP group demonstrated an improved tolerance to pain or a better understanding of pain, enabling them to walk longer distances at higher speeds. A positive effect of SUP was found for chair sit-and-reach test (p = 0.023), percentage of fat mass (p = 0.048), fat-free mass (p = 0.040), and total body water (p = 0.026), suggesting potential benefits attributed to the resistance strength exercises.
A 6-month combined treadmill and resistance exercise program improved walking ability, walking speed, lower body and lower back flexibility, and body composition in people with PAD and claudication.
运动疗法是一种公认的治疗外周动脉疾病（PAD）的非药物干预手段；然而，联合运动的效果仍在研究中。本研究旨在比较 6 个月的联合监督运动方案（SUP）与常规护理（UC）方法对有间歇性跛行的 PAD 患者的步行能力、身体适应性和外周血流的影响。
23 名男性参与者（年龄=64.1±6.2 岁，ABI=0.58±0.07）患有 PAD 和间歇性跛行，被分为 SUP 组（n=10）和 UC 组（n=13）。SUP 组进行结构化监督跑步机步行，结合三种阻力运动，每周三次；UC 组接受行走建议。主要结局指标为步行能力，评估在基线（M0）、3 个月（M3）和 6 个月（M6）时进行。
经过 6 个月的干预，SUP 组在 6 分钟步行测试（6MWT）中的绝对跛行时间（ACT，p=0.045）、最大步行时间（MWT，p=0.045）、最大步行距离（MWD，p=0.027）和停顿时间（p=0.045）方面的改善明显优于 UC 组。随着时间的推移，发现 6MWT 时的步行速度（Speed，p=0.001）和无跛行时的步行速度（Speed，p<0.001）显著增加，尽管两组之间没有发现显著差异。SUP 组在 Speed 和 Speed 方面分别增加了 0.8 公里/小时，而 UC 组分别增加了 0.3 公里/小时和 0.6 公里/小时。尽管间歇性跛行始终发生在同一时间，但 SUP 组表现出对疼痛的耐受力提高或对疼痛的理解改善，使他们能够以更高的速度行走更长的距离。SUP 对坐立起身测试（p=0.023）、体脂肪百分比（p=0.048）、去脂体重（p=0.040）和总体水量（p=0.026）有积极影响，这表明阻力强度运动可能带来益处。
6 个月的联合跑步机和阻力运动方案改善了有间歇性跛行的 PAD 患者的步行能力、步行速度、下肢和下背部柔韧性以及身体成分。
