Document Detail


Limb-specific and cross-transfer effects of arm-crank exercise training in patients with symptomatic peripheral arterial disease.
MedLine Citation:
PMID:  19388883     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Arm cranking is a useful alternative exercise modality for improving walking performance in patients with intermittent claudication; however, the mechanisms of such an improvement are poorly understood. The main aim of the present study was to investigate the effects of arm-crank exercise training on lower-limb O2 delivery in patients with intermittent claudication. A total of 57 patients with intermittent claudication (age, 70+/-8 years; mean+/-S.D.) were randomized to an arm-crank exercise group or a non-exercise control group. The exercise group trained twice weekly for 12 weeks. At baseline and 12 weeks, patients completed incremental tests to maximum exercise tolerance on both an arm-crank ergometer and a treadmill. Respiratory variables were measured breath-by-breath to determine peak VO2 (O2 uptake) and ventilatory threshold. Near-IR spectroscopy was used in the treadmill test to determine changes in calf muscle StO2 (tissue O2 saturation). Patients also completed a square-wave treadmill-walking protocol to determine VO2 kinetics. A total of 51 patients completed the study. In the exercise group, higher maximum walking distances (from 496+/-250 to 661+/-324 m) and peak VO2 values (from 17.2+/-2.7 to 18.2+/-3.4 ml.kg-1 of body mass.min-1) were recorded in the incremental treadmill test (P<0.05). After training, there was also an increase in time to minimum StO2 (from 268+/-305 s to 410+/-366 s), a speeding of VO2 kinetics (from 44.7+/-10.4 to 41.3+/-14.4 s) and an increase in submaximal StO2 during treadmill walking (P<0.05). There were no significant changes in the control group. The results suggest that the improvement in walking performance after arm-crank exercise training in patients with intermittent claudication is attributable, at least in part, to improved lower-limb O2 delivery.
Authors:
Garry Tew; Shah Nawaz; Irena Zwierska; John M Saxton
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-09-21
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  117     ISSN:  1470-8736     ISO Abbreviation:  Clin. Sci.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-09-21     Completed Date:  2009-12-01     Revised Date:  2010-02-22    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  405-13     Citation Subset:  IM    
Affiliation:
Centre for Sport and Exercise Science, Sheffield Hallam University, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arm / physiopathology*
Exercise Test / methods
Exercise Therapy / methods*
Exercise Tolerance / physiology
Humans
Intermittent Claudication / physiopathology,  rehabilitation*
Lower Extremity / blood supply
Middle Aged
Muscle, Skeletal / blood supply
Oxygen Consumption / physiology
Pulmonary Gas Exchange / physiology
Treatment Outcome
Walking / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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