ORIGINAL ARTICLE  PERIPHERAL ARTERIAL DISEASE 

International Angiology 2025 February;44(1):51-60

DOI: 10.23736/S0392-9590.25.05364-7

Copyright © 2025 EDIZIONI MINERVA MEDICA

language: English

Comparing arm-ergometry and treadmill exercise training on cardiovascular risk factors in peripheral artery disease: secondary analysis of the ARMEX trial

Sandra MAGALHÃES ^{1, 2} ✉, Mário SANTOS ^{2, 3, 4, 5, 6}, Sofia VIAMONTE ⁷, Joana MARTINS ⁸, Cristine SCHMIDT ⁹, Fernando RIBEIRO ¹⁰, Henrique CYRNE-CARVALHO ^{2, 3}

¹ Department of Physical and Rehabilitation Medicine, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ² UMIB - Unit for Multidisciplinary Research in Biomedicine, ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; ³ Department of Cardiology, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ⁴ Physiology Laboratory, Immuno-Physiology and Pharmacology Department, ICBAS - School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal; ⁵ CAC ICBAS-CHUP - Centro Académico Clínico Instituto de Ciências Biomédicas Abel Salazar, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ⁶ ITR - Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal; ⁷ Centro de Reabilitação do Norte, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; ⁸ Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de Santo António, Porto, Portugal; ⁹ Research Center in Physical Activity, Health and Leisure, CIAFEL, Faculty of Sport, University of Porto, Porto, Portugal; ¹⁰ Institute of Biomedicine - iBiMED and School of Health Sciences, University of Aveiro, Aveiro, Portugal

BACKGROUND: Peripheral artery disease (PAD), usually caused by atherosclerosis, is linked to high cardiovascular mortality. In this setting, a multidimensional cardiovascular rehabilitation program (CRP) comprising supervised exercise training can improve cardiovascular risk factors (CRF) control. This study compares the effects of an arm-ergometry supervised exercise training (AEx) with a standard treadmill protocol (TEx) on CRF.
METHODS: The ARMEX trial (ISRCTN54908548) was a single-center, single-blinded, parallel groups, noninferiority randomized clinical trial enrolling symptomatic PAD patients referred to a CRP. Participants were randomized (1:1) either to a 12-week AEx or TEx. Changes in blood pressure, lipid profile, glycated hemoglobin, body composition, physical activity levels, sedentary time and number of cigarettes smoked after the CRP were assessed.
RESULTS: Fifty-six patients (66±8.4 years; 87.5% male) were included: AEx (N.=28) and TEx (N.=28). Systolic and diastolic blood pressure decreased in both groups without significant between-group differences. Total cholesterol and low-density lipoprotein cholesterol decreased significantly only in the AEx group, without significant between-group differences. Weight, body mass index, waist circumference, waist/hip ratio and physical activity levels improved in both groups, without significant between-group differences. Smoking reduction was also similar between groups.
CONCLUSIONS: A multidimensional CRP, whether involving arm-ergometry or treadmill exercise, improved CRF control in symptomatic PAD patients. Both exercise modalities were equally effective, supporting their use as part of a comprehensive approach in this complex population.

KEY WORDS: Cardiac rehabilitation; Heart disease risk factors; Intermittent claudication; Peripheral artery disease; Upper extremities