Document Detail

The ischemic window: a method for the objective quantitation of the training effect in exercise therapy for intermittent claudication.
MedLine Citation:
PMID:  1495149     Owner:  NLM     Status:  MEDLINE    
Twenty-two patients with intermittent claudication were prospectively enrolled in a 12-week program of supervised, graded treadmill exercise therapy. Severity and distribution of arterial occlusive disease were ascertained by noninvasive determination of segmental lower extremity blood pressures and waveforms. No attempt was made to modify risk factors for atherosclerotic occlusive disease. The exercise-induced reduction of the ankle pressure and its recovery were recorded over time, and the area under this curve, the "ischemic window," represents the severity of the ischemic deficit. Absolute systolic ankle pressure, ankle-brachial index, maximum walking time, claudication pain time, and the ischemic window were measured before and after exercise training in all subjects. Maximum walking time and claudication pain time increased 659% and 846%, respectively, among the 19 patients completing the 12-week program (p = 0.001; p = 0.0002). These patients underwent a mean reduction of 58.7% in the ischemic window after a standardized workload (p less than 0.05), and this correlated with the degree of symptomatic improvement. Absolute ankle pressure and ankle-brachial index were unchanged after exercise training. This study confirms the utility of supervised exercise therapy in the treatment of intermittent claudication. The ischemic window is a useful method for quantifying the ischemic deficit produced by exercise and provides a reproducible means of documenting functional improvement in patients undergoing exercise training.
R L Feinberg; R T Gregory; J R Wheeler; S O Snyder; R G Gayle; F N Parent; R B Patterson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  16     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1992 Aug 
Date Detail:
Created Date:  1992-09-08     Completed Date:  1992-09-08     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:  244-50     Citation Subset:  IM    
Division of Vascular Surgery, Eastern Virginia Graduate School of Medicine, Norfolk 23510.
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MeSH Terms
Exercise Therapy*
Feasibility Studies
Intermittent Claudication / physiopathology*,  therapy*
Ischemia / physiopathology
Leg / blood supply
Middle Aged
Prospective Studies
Severity of Illness Index

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