Comparison of three training programmes on physiological adaptations in patients with peripheral vascular disease and intermittent claudication

Abstract

Introduction: The purpose of the study was to determine the effects of three training programmes on physiological adaptations in patients with peripheral vascular disease (PVD). Methodology: Before and after intervention all groups performed a standard graded treadmill exercise test (GTET) and a six-minute walk test (SMWT) to determine peak physiological parameters and walking distances. 31 patients were recruited from the Department of Vascular Surgery at Groote Schuur Hospital, CapeTown, South Africa and randomised to either a structured upper body strength training programme (UBST) or a structured dynamic (walking, cycling, and circuit) conventional exercise rehabilitation programme (CER). The final group of patients were instructed to walk as “much as possible” at home (CONT). Maximal walking distance (MWD), pain free walking distance (PFWD), VO2peak heart rate and perceived pain were measured. Results: MWD on the GTET increased in the CER group from 300 ± 198 to 514 ± 226 m; ([mean ± S.D.]; P = 0.002) but was unchanged in the UBST and CONT groups. Similarly VO2peak increased with CER (14.7 ± 3.0 ml O2 kg−1 min−1 vs. 19.4 ± 5.0 ml O2 kg−1 min−1; P = 0.008) but was unchanged in the UBST and CONT groups. During the SMWT the CER group improved PFWD (119 ± 101 to 159 ± 103 m; P = 0.0025) compared to the control and perceived pain decreased in the CER group (359 ± 126 to 292 ± 152 U; P = 0.009) compared to the UBST group. Conclusion: Structured CER improves physiological parameters and walking distances more than structured UBST does. CER is effective in as short a time period as six weeks. Unstructured verbal encouragement to exercise is an ineffective form of management.