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Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease.
Clin Physiol Funct Imaging. 2008 Jan; 28(1):32-7.CP

Abstract

INTRODUCTION

Peripheral atherosclerotic disease (PAD) is a condition characterized by low functional capacity which is associated with impaired free living, ambulation and low exercise tolerance. The purpose of this randomized controlled study was to evaluate whether changes in maximal walking time are associated with adaptations in cardiovascular function following supervised exercise.

METHODS

After ethics approval, 28 patients (63 +/- 11 years) completed a graded treadmill test (2 min stages, 3.2 km h(-1), with gradient increasing 2% every 2 min) until they reached level three or four on the claudication pain scale. Peak oxygen consumption was assessed on a breath-by-breath basis, by online expiratory gas analysis. Following a 40-min recovery period, peak cardiac output was measured using the non-invasive carbon dioxide rebreathing method described by Defares (J Appl Physiol, 13, 1958, 159). Peak cardiac power output was then computed using the equation described by Cooke et al. (Heart, 1998, 79, 289). Patients were randomly assigned to one of two groups: supervised, who exercised at the hospital twice weekly for 12 weeks or control, who received normal treatment which included encouragement to walk regularly.

RESULTS

After 12 weeks, there were no significant changes in body mass, peak oxygen consumption, peak cardiac output, peak heart rate, peak cardiac power output, respiratory exchange ratio or rating of perceived exertion in both the supervised and control group. There was a significant improvement (91%) in maximal walking distance following the supervised exercise programme. Although patients' peak cardiovascular measurements were unchanged, the patients in the supervised exercise group were able to complete a higher workload at the end of the 12 weeks of exercise, for the equivalent demands on the circulation system.

CONCLUSIONS

The findings from this study suggest that a short-term period of supervised exercise training results in an improved walking time in patients with limiting claudication because of PAD. It also demonstrated that the cardiovascular system becomes more efficient in meeting the demands of exercise. It is recommended that individuals with PAD should undertake exercise as a form of treatment.

Authors+Show Affiliations

Research Centre for Health Studies, Chalfont St Giles, Buckinghamshire, UK. lhodge01@bcuc.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18005078

Citation

Hodges, L D., et al. "Randomized Controlled Trial of Supervised Exercise to Evaluate Changes in Cardiac Function in Patients With Peripheral Atherosclerotic Disease." Clinical Physiology and Functional Imaging, vol. 28, no. 1, 2008, pp. 32-7.
Hodges LD, Sandercock GR, Das SK, et al. Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease. Clin Physiol Funct Imaging. 2008;28(1):32-7.
Hodges, L. D., Sandercock, G. R., Das, S. K., & Brodie, D. A. (2008). Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease. Clinical Physiology and Functional Imaging, 28(1), 32-7.
Hodges LD, et al. Randomized Controlled Trial of Supervised Exercise to Evaluate Changes in Cardiac Function in Patients With Peripheral Atherosclerotic Disease. Clin Physiol Funct Imaging. 2008;28(1):32-7. PubMed PMID: 18005078.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease. AU - Hodges,L D, AU - Sandercock,G R H, AU - Das,S K, AU - Brodie,D A, Y1 - 2007/11/14/ PY - 2007/11/17/pubmed PY - 2008/3/21/medline PY - 2007/11/17/entrez SP - 32 EP - 7 JF - Clinical physiology and functional imaging JO - Clin Physiol Funct Imaging VL - 28 IS - 1 N2 - INTRODUCTION: Peripheral atherosclerotic disease (PAD) is a condition characterized by low functional capacity which is associated with impaired free living, ambulation and low exercise tolerance. The purpose of this randomized controlled study was to evaluate whether changes in maximal walking time are associated with adaptations in cardiovascular function following supervised exercise. METHODS: After ethics approval, 28 patients (63 +/- 11 years) completed a graded treadmill test (2 min stages, 3.2 km h(-1), with gradient increasing 2% every 2 min) until they reached level three or four on the claudication pain scale. Peak oxygen consumption was assessed on a breath-by-breath basis, by online expiratory gas analysis. Following a 40-min recovery period, peak cardiac output was measured using the non-invasive carbon dioxide rebreathing method described by Defares (J Appl Physiol, 13, 1958, 159). Peak cardiac power output was then computed using the equation described by Cooke et al. (Heart, 1998, 79, 289). Patients were randomly assigned to one of two groups: supervised, who exercised at the hospital twice weekly for 12 weeks or control, who received normal treatment which included encouragement to walk regularly. RESULTS: After 12 weeks, there were no significant changes in body mass, peak oxygen consumption, peak cardiac output, peak heart rate, peak cardiac power output, respiratory exchange ratio or rating of perceived exertion in both the supervised and control group. There was a significant improvement (91%) in maximal walking distance following the supervised exercise programme. Although patients' peak cardiovascular measurements were unchanged, the patients in the supervised exercise group were able to complete a higher workload at the end of the 12 weeks of exercise, for the equivalent demands on the circulation system. CONCLUSIONS: The findings from this study suggest that a short-term period of supervised exercise training results in an improved walking time in patients with limiting claudication because of PAD. It also demonstrated that the cardiovascular system becomes more efficient in meeting the demands of exercise. It is recommended that individuals with PAD should undertake exercise as a form of treatment. SN - 1475-0961 UR - https://www.unboundmedicine.com/medline/citation/18005078/Randomized_controlled_trial_of_supervised_exercise_to_evaluate_changes_in_cardiac_function_in_patients_with_peripheral_atherosclerotic_disease_ L2 - https://doi.org/10.1111/j.1475-097X.2007.00770.x DB - PRIME DP - Unbound Medicine ER -