Document Detail

Training guided by pain threshold speed. Effects of a home-based program on claudication.
MedLine Citation:
PMID:  15767984     Owner:  NLM     Status:  MEDLINE    
AIM: To verify the effectiveness of a 120 day home-based program guided by the pain threshold speed (PTS). METHODS: Twenty-nine patients with stable claudication were measured for ankle pressure (AP), ankle-brachial index (ABI), PTS, maximal speed (Smax) on treadmill. Daily walking sessions at a speed 20-30% below PTS were prescribed. Determination of the training speed was supervised and facilitated at home. The program included a daily record of exercise data and symptoms, an intermediate PTS re-evaluation to adjust the training speed, and the reassessment of all the parameters after 120 days. RESULTS: Overall patients showed a reduction of systemic blood pressure (151.3+/-14.3 to 147.6+/-18.3 mmHg; 77.1 +/-9.1 to 72.4+/-8, p=0.008) while AP did not. ABI increased from 0.65+/-0.13 to 0.71+/- 0.18 (p=0.01). PTS and Smax rose from 3.2+/-1.1 to 4.2+/-1.5 km/h (p=0.0001) and from 3.9+/-1.3 to 4.6+/-1.3 km/h (p=0.0001), respectively. According to their compliance, patients were divided into 3 groups: 1) trained (T, n=14): exercise at the prescribed speed, 2) free-walkers (FW, n=7): walking speed markedly below PTS and 3) untrained (U, n=8): incomplete program compliance. T group showed symptom reduction up to pain disappearance. The ABI change (0.72+/-0.09 to 0.82+/- 0.16, p<0.02) was correlated to AP increase (r= 0.879). PTS and Smax rose from 3.6+/-1.1 to 5.4+/-0.8 km/h (p<0.02) and from 4.7+/-1.2 to 5.7+/-0.7 (p<0.02), respectively. FW showed improvement of all parameters, and U a better walking efficiency. CONCLUSIONS: In patients with claudication, a low-cost home-based program driven by PTS allows dramatic improvements of functional parameters.
F Manfredini; F Conconi; A M Malagoni; R Manfredini; N Basaglia; F Mascoli; A Liboni; P Zamboni
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  23     ISSN:  0392-9590     ISO Abbreviation:  Int Angiol     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-03-15     Completed Date:  2005-08-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  379-87     Citation Subset:  IM    
Vascular Diseases Center, University of Ferrara, Ferrara, Italy.
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MeSH Terms
Blood Flow Velocity / physiology
Exercise / physiology
Exercise Test / methods*
Exercise Therapy / methods*
Intermittent Claudication / physiopathology,  rehabilitation*,  ultrasonography
Pain Threshold / physiology*
Reproducibility of Results
Self Care / methods*
Time Factors
Treatment Outcome
Ultrasonography, Doppler

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

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