A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication

Abstract

Purpose: A pilot study was conducted to test the feasibility of supervised treadmill exercise training to improve functioning in study participants with peripheral arterial disease who did not have classical symptoms of intermittent claudication.

Methods: For this study, 32 men and women with peripheral arterial disease but no symptoms of claudication were randomized to exercise training or usual care. The intervention was a 12-week supervised treadmill walking program. Outcomes included 6-minute walk distance, maximum treadmill walking distance, and 4-meter walking velocity. Participant-reported community walking ability was measured with the Walking Impairment Questionnaire (WIQ). Inflammatory blood factor levels also were measured.

Results: Altogether, 25 participants who completed follow-up testing were included in intention-to-treat analyses. Of 24 participants (58%) randomized to exercise, 14 completed the entire exercise training program. The participants randomized to the intervention showed greater improvement in their WIQ walking speed score than the control subjects (P =.05). The participants randomized to the intervention showed improvements in their 6-minute walk distance (1134 +/- 347 vs 1266 +/- 295 feet; P =.03), maximal treadmill walking distance (389 +/- 248 vs 585 +/- 293 feet; P <.001), WIQ distance score (52.3 +/- 29.1 vs 63.1 +/- 25.1; P =.002), and WIQ speed score (48.7 +/- 26.8 vs 59.7 +/- 22.7; P =.008). The participants randomized to the control condition showed improvements in maximal treadmill walking distance (362 +/- 180 vs 513 +/- 237 feet; P =.014). There were no significant changes in the inflammatory blood factors after exercise.

Conclusions: This pilot study demonstrated that a supervised treadmill walking program may be feasible and may improve functioning for individuals with peripheral arterial disease who do not have classical symptoms of intermittent claudication. Further study is needed with a larger sample to identify optimal exercise methods that improve lower extremity functioning in men and women with peripheral arterial disease who do not have intermittent claudication.