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Strength Training in Walking Tolerance in Intermittent Claudication Patients

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StatusCompleted
Sponsors
University of Sao Paulo
Collaborators
Fundação de Amparo à Pesquisa do Estado de São Paulo

Keywords

Abstract

Background: Muscle atrophy and reduced leg strength are related to exercise intolerance in patients with intermittent claudication (IC), suggesting that strength training (ST) could improve exercise performance in these patients.
Objective: Analyze the effects of ST in walking capacity in patients with IC comparing with walking training (WT) effects.
Intervention: Patients were randomized into ST and WT. Both groups trained twice a week, for 12 weeks, at the same rate of perceived exertion. ST consisted of 3 sets of 10 repetitions of whole body exercises. WT consisted of 15 two-minute bouts of walking intercalated with 2 minutes of resting.
Measurements: Walking capacity, peak VO2, walking economy, ankle brachial index, ischemic window and knee extension strength

Description

From July 2005 to December 2006, three hundred patients with peripheral arterial disease, who were enrolled in a tertiary center specialized in vascular disease and were able to walk for at least 2 minutes at 2 miles per hour, were invited to a meeting at which explanations about this study were given. 80 patients attended the meeting, 60 of them decided to take part of the study, and 52 attended for the screening tests.

Patients were included in the study if they met the following criteria: Fontaine stage II peripheral arterial disease, symptoms of IC for at least 6 months, ankle/brachial index (ABI) at rest ≤ 0.90 in 1 or 2 legs, reduction of ABI after treadmill test, and exercise tolerance limited by IC. Patients were excluded under the following conditions: presence of chronic lung disease, inability to obtain ABI measurement due to noncompressible vessels, exercise tolerance limited by factors other than claudication (eg, dyspnea or orthopedic problems), poorly controlled blood pressure, presence of electrocardiogram response suggestive of myocardial ischemia during the exercise test, and history of revascularization in the previous year.

Procedures Patients were randomly (by drawing lots) divided into 2 groups: strength (ST, n = 17) and walking (WT, n = 17) training. They were evaluated at baseline (pre-training) and after 12 weeks of exercise training (post-training). During evaluations were assessed exercise tolerance and strength.

Both training programs (ST and WT) were supervised, conducted twice a week, lasted for 12 weeks, and started after a 2-week preconditioning-orientation phase. In both programs, rate of perceived exertion during exercise was kept similar and between 11 to 13 on the15-grade Borg scale. Furthermore, the duration of exercise sessions was prescribed as 30 min of exercise for ST and WT groups.

Dates

Last Verified: 09/30/2016
First Submitted: 01/26/2009
Estimated Enrollment Submitted: 03/08/2009
First Posted: 04/09/2009
Last Update Submitted: 10/23/2016
Last Update Posted: 12/14/2016
Date of first submitted results: 01/26/2009
Date of first submitted QC results: 03/08/2009
Date of first posted results: 04/09/2009
Actual Study Start Date: 06/30/2005
Estimated Primary Completion Date: 07/31/2008
Estimated Study Completion Date: 11/30/2008

Condition or disease

Peripheral Arterial Disease
Hypertension
Diabetes

Intervention/treatment

Behavioral: Walking training

Behavioral: Strength training

Phase

Phase 3

Arm Groups

ArmIntervention/treatment
Active Comparator: Strength training
Patients who performed strength training. The strength training program was composed by 8 exercises for whole body performed at sub-maximal intensity prescribed according to the patients self-perceived effort
Behavioral: Strength training
The strength training program consisted of 8 exercises (leg press, crunches, unilateral knee extension, seated row, unilateral knee flexion, seated bench press, calf raises on leg press, and seated back extension). In each exercise, subjects performed 3 sets of 10 repetitions with a 2-min interval between sets and exercises.
Active Comparator: Walking training
Patients who performed walking training. The walking training was performed in a treadmill using sub-maximal intensity prescribed based in patients self perceived effort
Behavioral: Walking training
The Walking Training program was performed using a treadmill. In each session, patients performed fifteen 2-min bouts of exercise followed by a 2-min rest interval, as previously described. Walking speed was set in order to induce perceived exertion of 11 to 13 and claudication pain in the last 30 seconds of each exercise bout.

Eligibility Criteria

Ages Eligible for Study 50 Years To 50 Years
Sexes Eligible for StudyAll
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

- Fontaine stage II peripheral arterial disease(14)

- Symptoms of intermittent claudication for at least 6 months

- Ankle/brachial index (ABI) at rest ≤ 0.90 in 1 or 2 legs

- Reduction of ABI after treadmill test

- Exercise tolerance limited by intermittent claudication

Exclusion Criteria:

- Presence of chronic lung disease

- Inability to obtain ABI measurement due to noncompressible vessels

- Exercise tolerance limited by factors other than claudication (e.g., dyspnea or orthopedic problems)

- Poorly controlled blood pressure

- Presence of electrocardiogram response suggestive of myocardial ischemia during the exercise test

- History of revascularization in the previous year

Outcome

Primary Outcome Measures

1. Total Walking Distance [12 weeks]

The maximal walking distance

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