Treadmill Exercise Improves Walking Endurance For Patients With PAD

Patients with peripheral arterial disease (PAD), which can include symptoms such as pain in the legs, who participated in supervised treadmill exercise improved their walking endurance and quality of life, according to a study in the January 14 issue of JAMA. The treadmill exercise also improved walking performance for PAD patients without the classic symptoms of pain in the leg muscles.

Lower extremity PAD (a condition that develops when the arteries that supply blood to the legs become completely or partially blocked as a result of plaque build-up) affects 1 in 16 U.S. adults 40 years or older. Men and women with PAD have greater functional impairment and more rapid rates of functional decline than those who do not have PAD, according to background information in the article. Most patients with PAD do not have symptoms of intermittent claudication (pain in the leg muscles that comes and goes), but PAD patients without these symptoms have greater functional impairment and functional decline than those without PAD. No prior exercise interventions have been tested on PAD participants with and without symptoms of intermittent claudication. Additionally, benefits of lower extremity resistance (strength) training for PAD patients are unclear.

Mary M. McDermott, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, and colleagues conducted a study to determine whether supervised treadmill exercise and lower extremity-resistance training improves functional performance and other outcomes among participants with PAD with and without intermittent claudication symptoms. The randomized controlled clinical trial included 156 patients with PAD who were randomly assigned to supervised treadmill exercise, to lower extremity resistance training, or to a control group, for six months. Patients were tested for six-minute walk performance and a short physical performance battery, as well as brachial artery flow-mediated dilation (a measurement of change in the diameter of an artery in the arm), treadmill walking performance, the Walking Impairment Questionnaire, and the 36-Item Short Form Health Survey physical functioning (SF-36 PF) score.