Document Detail

The inflammatory response to upper and lower limb exercise and the effects of exercise training in patients with claudication.
MedLine Citation:
PMID:  11174795     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We have previously shown that a program of upper limb exercise training can induce significant improvements in walking distance in patients with claudication. This study assessed whether upper limb exercise avoids the systemic inflammatory responses associated with lower limb exercise and also whether the inflammatory response to acute lower limb exertion is modified by a program of supervised exercise training.
METHODS: Fifty-two patients with stable intermittent claudication were randomized into two groups who underwent 6 weeks of supervised upper (n = 26) or lower (n = 26) limb cardiorespiratory exercise training. A parallel control group (n = 15) was provided with lifestyle advice only. Neutrophil activation markers (CD11b and CD66b) and plasma levels of von Willebrand factor (marker of endothelial damage) in response to an acute bout of sustained upper and lower limb exercise were assessed before and after the period of training. Plasma levels of soluble E-selectin (marker of endothelial activation) were also determined before and after the training period.
RESULTS: An acute bout of sustained lower limb exercise significantly increased the intensity of CD11b and CD66b expression by peripheral blood neutrophils in all groups, whereas upper limb exercise had no effect. Resting neutrophil expression of CD11b and CD66b and circulating von Willebrand factor levels were unaffected by the training program, as were the inflammatory responses to an acute bout of sustained upper and lower limb muscular work, despite the fact that both training programs significantly increased walking distances.
CONCLUSIONS: These findings indicate that upper limb exercise training programs may offer certain advantages over currently prescribed lower limb programs. Our results show that exercising nonischemic muscles in a way that promotes improved cardiorespiratory function and walking capacity can avoid the potentially deleterious systemic inflammatory responses associated with lower limb exertion in patients with stable intermittent claudication.
S Nawaz; R D Walker; C H Wilkinson; J M Saxton; A G Pockley; R F Wood
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  33     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-22     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  392-9     Citation Subset:  IM    
Division of Clinical Sciences (NGH), University of Sheffield, and The Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, UK.
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MeSH Terms
Aged, 80 and over
Antigens, CD
Antigens, Neoplasm*
Cell Adhesion Molecules*
E-Selectin / blood
Exercise Therapy*
Exercise Tolerance
GPI-Linked Proteins
Intermittent Claudication / blood,  immunology*,  therapy
Macrophage-1 Antigen / blood
Membrane Glycoproteins / blood
Middle Aged
Neutrophil Activation*
Neutrophils / immunology
von Willebrand Factor / analysis*
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, Neoplasm; 0/CEACAM8 protein, human; 0/Cell Adhesion Molecules; 0/E-Selectin; 0/GPI-Linked Proteins; 0/Macrophage-1 Antigen; 0/Membrane Glycoproteins; 0/von Willebrand Factor

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