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A Journal on Angiology

Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 1999 June;18(2):103-12

language: English

Why is train­ing effec­tive in the treat­ment of ­patients with inter­mit­tent claud­i­ca­tion?

Remijnse-Tamerius H. C. M., Duprez D. *, De Buyzere M. *, Oeseburg B., Clement D. L. *

From the Department of Physiology, University of Nijmegen, Nijmegen, The Netherlands
* Department of Cardiology and Angiology, University Hospital, Gent, Belgium


Patients with periph­er­al arte­ri­al obstruc­tive dis­ease (PAOD) often have com­plaints of inter­mit­tent claud­i­ca­tion. This caus­es a great lim­i­ta­tion in the qual­ity of life ­because of reduc­tion in walk­ing abil­ity. PAOD is asso­ciat­ed with ­increased mor­bid­ity and mor­tal­ity. Beside other ther­a­pies, train­ing has been shown to be an effec­tive treat­ment ­option for ­patients with inter­mit­tent claud­i­ca­tion. Exercise train­ing sig­nif­i­cant­ly increas­es walk­ing dis­tance and con­se­quent­ly the func­tion­al beha­vi­our of the ­patient. Several ­authors have iden­ti­fied dif­fer­ent mech­a­nisms ­involved in this ben­e­fi­cial ­effect. The most impor­tant are dis­cussed in this ­review, name­ly adap­ta­tion or redis­tri­bu­tion of the periph­er­al blood flow, inhi­bi­tion of the pro­gres­sion of the ath­e­ros­cle­rot­ic dis­ease, chang­es in blood rhe­ol­o­gy, meta­bol­ic chang­es, chang­es in skel­e­tal mus­cle mor­phol­o­gy, eco­nom­isa­tion of walk­ing, a ­change in pain per­cep­tion and an ­effect on the car­di­o­vas­cu­lar ­system. It is con­clud­ed that train­ing works ­through a com­bi­na­tion of mech­a­nisms. Further ­research is need­ed to clar­i­fy the pre­cise mech­a­nisms.

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