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Rivista di Angiologia

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 2000 March;19(1):8-13


lingua: Inglese

Exercise training in intermittent claudication

Gibellini R., Fanello M. *, Ferrari Bardile A., Salerno M. *, Aloi T.

From the "Salvatore Maugeri" Foundation, IRCCS, Rehabilitation Institute, Section of Angiology, Montescano (PV) Italy * Division of Cardiology, Tradate (VA) Italy


Background. Peripheral arte­ri­al occlu­sive dis­ease (PAOD) at II stage ­results in a mod­er­ate to ­severe impair­ment in walk­ing abil­ity. Aim of this study, con­trolled and ran­dom­ized, was to eval­u­ate the effi­ca­cy of an inten­sive 4 weeks exer­cise train­ing in PAOD fol­lowed by a six-­month peri­od and to ana­lyse the risk fac­tors for ath­ero­scler­o­sis and the site of the ­lesion for pos­sible pre­dic­tors of ­result out­come.
Methods. Patients with PAOD were includ­ed in the study (ankle/arm ratio ≤0.7 and ≤0.5 after exer­cise) with ­initial claud­i­ca­tion dis­tance (ICD) ≤200 m and abso­lute claud­i­ca­tion dis­tance (ACD) ≤500 m eval­u­at­ed on a con­stant-load tread­mill test (3 km/hr, 0% slope). Forty ­patients were ran­dom­ized (all with anti­plate­let ther­a­py): 20 to a super­vised walk­ing exer­cise (mean ICD 121.8 m, ACD 289.7 m) and 20 to a non exer­cis­ing con­trol group (ICD 111.6 m, ACD 230.1 m). Both ­groups were test­ed at 4 weeks (T1) and 6 ­months (T2). Training group was ­enrolled in a 4-week super­vised train­ing pro­gram.
Results. In the train­ing group 10% of ­patients ­became asymp­to­mat­ic (>1000 m). At T1 ICD ­increased 141% (p<0.001) and ACD was with low-pain-claud­i­ca­tion >1000 m in 50%, at T2 ICD was 200% (p<0.05) with 70% of asymp­to­mat­ic for ICD and ACD. Control group has a no sig­nif­i­cant ­increase of ICD and ACD at T1 and T2. Only arte­ri­al hyper­ten­sion and inter­mit­tent claud­i­ca­tion sever­ity ­emerged as neg­a­tive pre­dic­tive fac­tors for the ­results of train­ing.
Conclusions. Vascular train­ing pro­duc­es a sig­nif­i­cant and last­ing improve­ment in walk­ing dis­tance in PAOD.

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