The Group Oriented Arterial Leg Study (GOALS) to improve walking performance in patients with peripheral arterial disease. Community-based walking exercise for peripheral artery disease: An exploratory pilot study Initial Results of a 12-week, Institution-based, Supervised Exercise Rehabilitation Program for the Management of Peripheral Arterial Disease One-year effect of a supervised exercise programme on functional capacity and quality of life in peripheral arterial disease Unsupervised Exercise and Mobility Loss in Peripheral Artery Disease: A Randomized Controlled Trial High-intensity progressive resistance training improves flat-ground walking in older adults with symptomatic peripheral arterial disease. Effectiveness of a New Exercise Program after Lower Limb Arterial Blood Flow Surgery in Patients with Peripheral Arterial Disease: A Randomized Clinical Trial Effects of a long-term exercise program on lower limb mobility, physiological responses, walking performance, and physical activity levels in patients with peripheral arterial disease. Comparison of Effect of Two Exercise Programs on Activities of Daily Living in Individuals with Dementia: A 9-Week Randomized, Controlled Trial. Step‐Monitored Home Exercise Improves Ambulation, Vascular Function, and Inflammation in Symptomatic Patients With Peripheral Artery Disease: A Randomized Controlled Trial Exercise rehabilitation improves functional outcomes and peripheral circulation in patients with intermittent claudication: a randomized controlled trial. Supervised exercise, stent revascularization, or medical therapy for claudication due to aortoiliac peripheral artery disease: the CLEVER study. Maintaining Physical Fitness and Function in Alzheimer’s Disease Randomized controlled trial of supervised exercise to evaluate changes in cardiac function in patients with peripheral atherosclerotic disease A group-mediated, home-based physical activity intervention for patients with peripheral artery disease: effects on social and psychological function Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. A pilot exercise intervention to improve lower extremity functioning in peripheral arterial disease unaccompanied by intermittent claudication.
People with lower extremity peripheral artery disease ( PAD ) have greater functional impairment and faster functional decline than those without PAD . We describe methods for the Group Oriented Arterial Leg Study ( GOALS ) , an ongoing r and omized controlled clinical trial design ed to determine whether a Group-Mediated Cognitive Behavioral ( GMCB ) intervention improves functional performance in PAD participants , compared to a health education control condition . In GOALS , PAD participants were r and omized to either an intervention or a health education control condition in a parallel design . Both conditions consist of weekly group sessions with other PAD participants . In the intervention , cognitive behavioral techniques are used to assist participants in setting and adhering to home-based walking exercise goals . Participants are encouraged to walk for exercise at home at least 5 days/week . In the control condition , participants receive lectures on health-related topics . After 6 months of on-site weekly sessions , participants are transitioned to telephone follow-up for another 6 months . Participants in the intervention are asked to continue home walking exercise .  The primary outcome is change in six-minute walk performance between baseline and six-month follow-up . Secondary outcomes include change in six-minute walk performance at 12-month follow-up , and change in treadmill walking performance , the Walking Impairment Question naire , quality of life , and physical activity at six and 12-month follow-up . In conclusion , if our group-mediated cognitive behavioral intervention is associated with improved walking performance in individuals with PAD , results will have major public health implication s for the large and growing number of people with PAD Supervised walking exercise is an effective treatment to improve walking ability of patients with peripheral artery disease ( PAD ) , but few exercise programs in community setting s have been effective . The aim of this study was to determine the efficacy of a community-based walking exercise program with training , monitoring and coaching ( TMC ) components to improve exercise performance and patient-reported outcomes in PAD patients . This was a r and omized , controlled trial including PAD patients ( n=25 ) who previously received peripheral endovascular therapy or presented with stable claudication . Patients r and omized to the intervention group received a comprehensive community-based walking exercise program with elements of TMC over 14 weeks . Patients in the control group did not receive treatment beyond st and ard advice to walk . The primary outcome in the intent-to-treat ( ITT ) analyses was peak walking time ( PWT ) on a grade d treadmill . Secondary outcomes included claudication onset time ( COT ) and patient-reported outcomes assessed via the Walking Impairment Question naire ( WIQ ) . Intervention group patients ( n=10 ) did not significantly improve PWT when compared with the control group patients ( n=10 ) ( mean±st and ard error : + 2.1±0.7 versus 0.0±0.7 min , p=0.052 ) . Changes in COT and WIQ scores were greater for intervention patients compared with control patients ( COT : + 1.6±0.8 versus −0.6±0.7 min , p=0.045 ; WIQ : + 18.3±4.2 versus −4.6±4.2 % , p=0.001 ) . This pilot using a walking program with TMC and an ITT analysis did not improve the primary outcome in PAD patients . Other walking performance and patient self-reported outcomes were improved following exercise in community setting s. Further study is needed to determine whether this intervention improves outcomes in a trial employing a larger sample size This study assessed the effectiveness of a 12-week , institution-based , supervised exercise rehabilitation program with atherogenic risk factor modification in improving cardiovascular profile , ambulatory function , and quality of life of patients with peripheral arterial disease ( PAD ) by comparing pre- and postprogram measurements . Participants were prospect ively enrolled .  Cardiovascular profile variables , ambulatory function tests , and quality of life question naires were evaluated . Of 101 institution-based program participants , 69 completed the 12-session minimum and 47 completed a postprogram evaluation . Mean postprogram results were significantly different from preprogram results , corresponding to improvement , for the following variables : triglyceride levels ( p = .036 ) , both function tests ( p < .001 for both ) , four of five Walking Impairment Question naire measurements , and Intermittent Claudication Question naire score ( p = .001 ) . This supervised exercise program improved the cardiovascular profiles , ambulatory function , and quality of life of PAD patients completing the program and is a viable adjunct to drug therapy and surgical intervention Purpose : Peripheral arterial disease ( PAD ) is a chronic , progressive disease with a significant cardiovascular and cerebrovascular risk burden and a considerable impact on functional capacity and quality of life ( QoL ) . Exercise programmes result in significant improvements in walking distances but long-term effects are uncertain . The aim of this study was to assess the one-year effects of participation in a 12-week supervised exercise programme on functional capacity and QoL for PAD patients . Methods : Patients were r and omly allocated to a control ( n = 16 ) or an exercise ( n = 28 ) group . Data regarding functional capacity ( Walking Impairment Question naire WIQ ) , disease-specific QoL ( Intermittent Claudication Question naire ICQ ) and generic QoL ( SF-36 ) were collected at baseline , 12 weeks and 1 year . Results : At 12 weeks , there was a trend towards improved QoL in both groups , with a tendency for greater improvement in the exercise group ( p = 0.066 ) and a trend towards improved functional capacity ( WIQ Stair-climbing p = 0.093 ) in the exercise group . At 1 year , ICQ scores in the exercise group were considerably better than those in the control group ( p = 0.058 ) , reflecting improved QoL and maintenance of benefits . Conclusions : Participation in a supervised exercise programme results in improvements in functional capacity and QoL at 1 year post-participation . Implication s for Rehabilitation Peripheral arterial disease has a considerable impact on functional capacity and quality of life Functional capacity and quality of life are improved in patients with peripheral arterial disease up to 1 year post-participation in supervised exercise Improvements at 1 year are reduced from those noted immediately following an exercise Background Few medical therapies improve lower extremity functioning in people with lower extremity peripheral artery disease ( PAD ) . Among people with PAD , we studied whether a group-mediated cognitive behavioral intervention promoting home-based unsupervised exercise prevented mobility loss and improved functional performance compared to control . Methods and Results One hundred ninety-four PAD participants were r and omized . During months 1 to 6 , the intervention group met weekly with other PAD participants and a facilitator . Group support and self-regulatory skills were used to help participants adhere to walking exercise . Ninety-percent of exercise was conducted at or near home . The control group attended weekly lectures . During months 6 to 12 , each group received telephone contact only . Primary outcomes have been reported . Here we compare changes in exploratory outcomes of mobility loss ( the inability to climb a flight of stairs or walk one-quarter mile without assistance ) , walking velocity , and the Short Physical Performance Battery . Compared to controls , fewer participants r and omized to the intervention experienced mobility loss at 6-month follow-up : 6.3 % versus 26.5 % , P=0.002 , odds ratio=0.19 ( 95 % CI=0.06 to 0.58 ) and at 12-month follow-up : 5.2 % versus 18.5 % , P=0.029 , odds ratio=0.24 ( 95 % CI=0.06 to 0.97 ) . The intervention improved fast-paced 4-m walking velocity at 6-month follow-up ( P=0.005 ) and the Short Physical Performance Battery at 12-month follow-up ( P=0.027 ) , compared to controls . Conclusions In exploratory analyses , a group-mediated cognitive behavioral intervention promoting unsupervised walking exercise prevented mobility loss and improved functioning at 6- and 12-month follow-up in PAD patients . Clinical Trial Registration URL : http:// clinical trials.gov . Unique identifier : NCT00693940 OBJECTIVES To assess the efficacy of whole-body progressive resistance training ( PRT ) as a treatment for the symptoms of peripheral arterial disease ( PAD ) in older adults . DESIGN R and omized controlled pilot trial . SETTING University clinical weight training facility in Sydney , Australia . PARTICIPANTS Twenty-two older adults with symptomatic PAD . INTERVENTIONS The efficacy of supervised whole-body high-intensity PRT ( H-PRT ) with low-intensity nonprogressive resistance training ( L-RT ) and a usual care control group that performed unsupervised walking for 6 months was compared . MEASUREMENTS Pilot outcome measures included 6-minute walk ( 6 MW ) outcomes , body composition , dynamic muscle strength and endurance , and performance-based tests of function . RESULTS Mean age was 71.1 ± 7.2 . Mean ankle brachial index was 0.55 ± 0.13 .  Exercise adherence was similar in all groups ( P = .29 ) . H-PRT ( n = 8) improved total 6MW distance ( mean difference ( MD ) 62.6 ± 58.0 m , P = .02 ) significantly more than L-RT ( n = 7 ; MD=-48.2 ± 67.6 m ) and controls ( n = 7 ; MD=-9.9 ± 52.9 m ) . Change in 6MW onset of claudication was significantly and independently related to change in bilateral calf endurance ( correlation coefficient ( r ) = 0.65 , P = .03 ) , and change in 6MW distance was significantly and independently related to change in bilateral hip extensor endurance ( r = 0.71 , P = .02 ) in all groups . CONCLUSION H-PRT  significantly improved 6MW ability in older adults with intermittent claudication from PAD , whereas L-RT and unsupervised walking did not . Improvement in walking ability was significantly related to improvements in bilateral calf and hip extensor endurance , supporting further investigations targeted at musculoskeletal impairment in this cohort Objective : The aim of this study was to evaluate the effectiveness of a supervised exercise program ( SEP ) plus at home nonsupervised exercise therapy ( non-SET ) on functional status , quality of life ( QoL ) and hemodynamic response in post-lower-limb bypass surgery patients . Results : One hundred and seventeen patients were r and omized to an intervention ( n = 57 ) or a control group ( n = 60 ) . A new individual SEP was design ed for patients with peripheral arterial disease ( PAD ) and applied to the studied subjects of the intervention group who also continued non-SET at home , whereas those assigned to the control group received just usual SEP according to a common cardiovascular program . The participants of the study were assessed by a 6-min walking test ( 6 MWT ) , an ankle-brachial index ( ABI ) , and the Medical Outcomes Study Short Form-36 ( SF-36 ) of QoL at baseline , at 1 and 6 months after surgery . A significant improvement was observed in the walked distance in the intervention group after 6 months compared with the control group ( p < 0.001 ) . The intervention group had significantly higher QoL score in the physical and mental component of SF-36 ( p < 0.05 ) . Conclusions : A 6-month application of the new SEP and non-SET at home has yielded significantly better results in walking distance and QoL in the intervention group than in the controls OBJECTIVE The purpose of the study was to examine the effects of a 12-month exercise program on lower limb mobility ( temporal-spatial gait parameters and gait kinematics ) , walking performance , peak physiological responses , and physical activity levels in individuals with symptoms of intermittent claudication due to peripheral arterial disease ( PAD-IC ) . METHODS Participants ( n = 21 ) with an appropriate history of PAD-IC , ankle-brachial pressure index ( ABI ) < 0.9 in at least one leg and a positive Edinburgh claudication question naire response were prospect ively recruited . Participants were r and omly allocated to either a control PAD-IC group ( CPAD-IC )  ( n = 11 ) that received st and ard medical therapy and a treatment PAD-IC group ( TPAD-IC ) ( n = 10 ) , which also took part in a 12-month supervised exercise program . A further group of participants ( n = 11 ) free of PAD ( ABI > 0.9 ) and who were non-regular exercisers were recruited from the community to act as age and mass matched controls ( CON ) . Lower limb mobility was determined via two-dimensional video motion analysis . A grade d treadmill test was used to assess walking performance and peak physiological responses to exercise . Physical activity levels were measured via a 7-day pedometer recording . Differences between groups were analyzed via repeated measures analysis of variance ( ANOVA ) . RESULTS The 12-month supervised exercise program had no significant effect on lower limb mobility , peak physiological responses , or physical activity levels in TPAD-IC compared with CPAD-IC participants . However , the TPAD-IC participants demonstrated significantly greater walking performance ( 171 % improvement in pain free walking time and 120 % improvement in maximal walking time compared with baseline ) . CONCLUSION The results of this study confirm that a 12-month supervised exercise program will result in improved walking performance , but does not have an impact on lower limb mobility , peak physiological responses , or physical activity levels of PAD-IC patients OBJECTIVES To compare the effects of two exercise programs on proxy- and performance-based measures of activities of daily living ( ADLs ) and to explore potential motor and cognitive mediators underlying ADL improvements in individuals with dementia . DESIGN A parallel , three-group , single-blind , r and omized , controlled trial . SETTING Psychogeriatric wards . PARTICIPANTS Individuals with dementia ( mean age 85.6 ± 5.1 ) . INTERVENTIONS Each 9-week intervention consisted of thirty-six 30-minute sessions . A combined group ( n = 35 ) participated in two strength and two walking sessions , an aerobic group ( n = 35 ) participated in four walking sessions , and a social control group ( n = 35 ) participated in four nonexercise social visits per week . The social group was used as a reference for the mediation analysis , which was performed in the combined and aerobic groups . MEASUREMENTS ADLs were assessed using the Katz index ( proxy-reported ADL performance ) , Erlangen-ADL test ( E-ADL ) ( instrumental ADL performance ) , and 7-item Physical Performance Test ( PPT-7 ) ( physical ADL performance ) . RESULTS There was a group effect for Katz index ( P = .02 ) , E-ADL ( P < .001 ) , and PPT-7 ( P = .003 ) . Differences from baseline to after the intervention were similar in the combined and aerobic groups . Exercise-induced changes in global cognition mediated changes in Katz index ( 95 % confidence interval ( CI ) = 0.05 - 0.41 ) , leg muscle strength mediated changes in E-ADL ( 95 % CI = 0.03 - 0.43 ) , and leg muscle strength ( 95 % CI = 0.01 - 0.36 ) and walking endurance ( 95 % CI = 0.01 - 0.43 ) mediated changes in PPT-7 only in the combined group . CONCLUSION Physical exercise can improve ADL levels in individuals with dementia , but improvements are small and seem independent of exercise type . Additional analyses suggest that combined aerobic and strength exercise may be more effective than aerobic-only exercise to effectively target ADL dysfunction in individuals with dementia . Future research is warranted to justify these exercise-specific findings Background This prospect i ve , r and omized , controlled clinical trial compared changes in primary outcome measures of claudication onset time ( COT ) and peak walking time ( PWT ) , and secondary outcomes of submaximal exercise performance , daily ambulatory activity , vascular function , inflammation , and calf muscle hemoglobin oxygen saturation ( StO2 ) in patients with symptomatic peripheral artery disease ( PAD ) following new exercise training using a step watch ( NEXT Step ) home‐exercise program , a supervised exercise program , and an attention‐control group . Methods and Results One hundred eighty patients were r and omized . The NEXT Step program and the supervised exercise program consisted of intermittent walking to mild‐to‐moderate claudication pain for 12 weeks , whereas the controls performed light resistance training . Change scores for COT ( P<0.001 ) , PWT ( P<0.001 ) , 6‐minute walk distance ( P=0.028 ) , daily average cadence ( P=0.011 ) , time to minimum calf muscle StO2 during exercise ( P=0.025 ) , large‐artery elasticity index ( LAEI ) ( P=0.012 ) , and high‐sensitivity C‐reactive protein ( hsCRP ) ( P=0.041 ) were significantly different among the 3 groups . Both the NEXT Step home program and the supervised exercise program demonstrated a significant increase from baseline in COT , PWT , 6‐minute walk distance , daily average cadence , and time to minimum calf StO2 . Only the NEXT Step home group had improvements from baseline in LAEI , and hsCRP ( P<0.05 ) . Conclusions NEXT Step home exercise utilizing minimal staff supervision has low attrition , high adherence , and is efficacious in improving COT and PWT , as well as secondary outcomes of submaximal exercise performance , daily ambulatory activity , vascular function , inflammation , and calf muscle StO2 in symptomatic patients with PAD . Clinical Trial Registration URL : Clinical Trials.gov . Unique Identifier : NCT00618670 OBJECTIVE To determine the effects of a 6-month exercise program on ambulatory function , free-living daily physical activity , peripheral circulation , and health-related quality of life ( QOL ) in disabled older patients with intermittent claudication . DESIGN Prospect i ve , r and omized controlled trial . SETTING University Medical ( Center and Veterans Affairs Medical Center , Baltimore , Maryl and . PARTICIPANTS Thirty-one of 61 patients with Fontaine stage II peripheral arterial occlusive disease ( PAOD ) were r and omized to  exercise rehabilitation and 30 to  usual-care control . Three patients from the exercise group and six patients from the control group dropped out , leaving 28 and 24 patients , respectively , completing the study in each group . INTERVENTION Six months of exercise rehabilitation . MEASUREMENTS Treadmill distance walked to onset of claudication and to maximal claudication , ambulatory function , peripheral circulation , perceived QOL , and daily physical activity . RESULTS Compliance with the exercise program was 73 % of the possible sessions . Exercise rehabilitation increased treadmill distance walked to onset of claudication by 134 % ( P < .001 ) and to maximal claudication by 77 % ( P < .001 ) , walking economy by 12 % ( P = .003 ) , 6-minute walk distance by 12 % ( P < .001 ) , and maximal calf blood flow by 30 % ( P < .001 ) . Changes in distance walked to maximal pain correlated with changes in walking economy ( r = -.50 , P = .013 ) and changes in maximal calf blood flow ( r = .38 , P = .047 ) . Exercise rehabilitation increased accelerometer-derived daily physical activity by 38 % ( P < .001 ) ; this change correlated with the change in distance walked to maximal pain ( r = .45 , P = .020 ) . These improvements were significantly better than the changes in the control group ( P < .05 ) . CONCLUSION Improvements in claudication following exercise rehabilitation in older PAOD patients are dependent on improvements in peripheral circulation and walking economy . Improvement in treadmill claudication distances in these patients translated into increased accelerometer-derived physical activity in the community , which enabled the patients to become more functionally independent BACKGROUND Treatment for claudication that is due to aortoiliac peripheral artery disease ( PAD ) often relies on stent revascularization ( ST ) . However , supervised exercise ( SE ) is known to provide comparable short-term ( 6-month ) improvements in functional status and quality of life . Longer-term outcomes are not known . OBJECTIVES The goal of this study was to report the longer-term ( 18-month ) efficacy of SE compared with ST and optimal medical care ( OMC ) . METHODS Of 111 patients with aortoiliac PAD r and omly assigned to receive OMC , OMC plus SE , or OMC plus ST , 79 completed the 18-month clinical and treadmill follow-up assessment . SE consisted of 6 months of SE and an additional year of telephone-based exercise counseling . Primary clinical outcomes included objective treadmill-based walking performance and subjective quality of life . RESULTS Peak walking time improved from baseline to 18 months for both SE ( 5.0 ± 5.4 min ) and ST ( 3.2 ± 4.7 min ) significantly more than for OMC ( 0.2 ± 2.1 min ; p < 0.001 and p = 0.04 , respectively ) . The difference between SE and ST was not significant ( p = 0.16 ) . Improvement in claudication onset time was greater for SE compared with OMC , but not for ST compared with OMC . Many disease-specific quality -of-life scales demonstrated durable improvements that were greater for ST compared with SE or OMC . CONCLUSIONS Both SE and ST had better 18-month outcomes than OMC . SE and ST provided comparable durable improvement in functional status and in quality of life up to 18 months . The durability of claudication exercise interventions merits its consideration as a primary PAD claudication treatment Background : Little is known about how aerobic exercise affects physical functioning in persons with Alzheimer ’s disease ( AD ) . Methods : This pilot study used a 1-group repeated measures design to examine the feasibility and impact of a 6-month individualized moderate intensity cycling intervention on cardiorespiratory fitness and lower extremity function in 8 participants aged 81.4 ± 3.58 . Cardiorespiratory fitness was measured using the shuttle walk and modified YMCA cycle ergometer tests , and lower extremity function was measured using the Short Physical Performance Battery ( SPPB ) at baseline , 3 months and 6 months . Results : The YMCA test showed a significant reduction in heart rate at stage 2 ( 103.4 vs 90.9 vs 91.6 ; P = .01 ) , while no significant changes were observed in the shuttle walk and SPPB tests . Conclusions : Persons with AD are able to improve cardiorespiratory conditioning from aerobic exercise . R and omized , controlled trials are needed to confirm these findings . Implication s for future research are detailed 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 r and omized controlled study was to evaluate whether changes in maximal walking time are associated with adaptations in cardiovascular function following supervised exercise Background PAD is a disabling , chronic condition of the lower extremities that affects approximately 8 million people in the United States . The purpose of this study was to determine whether an innovative home-based walking exercise program for patients with peripheral artery disease ( PAD ) improves self-efficacy for walking , desire for physical competence , satisfaction for physical functioning , social functioning , and acceptance of PAD related pain and discomfort . Methods The design was a 6-month r and omized controlled clinical trial of 194 patients with PAD . Participants were r and omized to 1 of 2 parallel groups : a home-based group-mediated cognitive behavioral walking intervention or an attention control condition . Results Of the 194 participants r and omized , 178 completed the baseline and 6-month follow-up visit . The mean age was 70.66 ( ±9.44 ) and was equally represented by men and women . Close to half of the cohort was African American . Following 6-months of treatment , the intervention group experienced greater improvement on self-efficacy ( p = .0008 ) , satisfaction with functioning ( p = .0003 ) , pain acceptance ( p = .0002 ) , and social functioning ( p = .0008 ) than the control group ; the effects were consistent across a number of potential moderating variables . Change in these outcomes was essentially independent of change in 6-minute walk performance . Trial registration [ Clinical Trials.gov Identifier : NCT00693940 CONTEXT Neither supervised treadmill exercise nor strength training for patients with peripheral arterial disease ( PAD ) without intermittent claudication have been established as beneficial . OBJECTIVE To determine whether supervised treadmill exercise or lower extremity resistance training improve functional performance of patients with PAD with or without claudication . DESIGN , SETTING , AND PARTICIPANTS R and omized controlled clinical trial performed at an urban academic medical center between April 1 , 2004 , and August 8 , 2008 , involving 156 patients with PAD who were r and omly assigned to supervised treadmill exercise , to lower extremity resistance training , or to a control group .  MAIN OUTCOME MEASURES Six-minute walk performance and the short physical performance battery . Secondary outcomes were brachial artery flow-mediated dilation , treadmill walking performance , the Walking Impairment Question naire , and the 36-Item Short Form Health Survey physical functioning ( SF-36 PF ) score . RESULTS For the 6-minute walk , those in the supervised treadmill exercise group increased their distance walked by 35.9 m ( 95 % confidence interval [ CI ] , 15.3 - 56.5 m ; P < .001 ) compared with the control group , whereas those in the resistance training group increased their distance walked by 12.4 m ( 95 % CI , -8.42 to 33.3 m ; P = .24 ) compared with the control group . Neither exercise group improved its short physical performance battery scores . For brachial artery flow-mediated dilation , those in the treadmill group had a mean improvement of 1.53 % ( 95 % CI , 0.35%-2.70 % ; P = .02 ) compared with the control group . The treadmill group had greater increases in maximal treadmill walking time ( 3.44 minutes ; 95 % CI , 2.05 - 4.84 minutes ; P < .001 ) ; walking impairment distance score ( 10.7 ; 95 % CI , 1.56 - 19.9 ; P = .02 ) ; and SF-36 PF score ( 7.5 ; 95 % CI , 0.00 - 15.0 ; P = .02 ) than the control group . The resistance training group had greater increases in maximal treadmill walking time ( 1.90 minutes ; 95 % CI , 0.49 - 3.31 minutes ; P = .009 ) ; walking impairment scores for distance ( 6.92 ; 95 % CI , 1.07 - 12.8 ; P = .02 ) and stair climbing ( 10.4 ; 95 % CI , 0.00 - 20.8 ; P = .03 ) ; and SF-36 PF score ( 7.5 ; 95 % CI , 0.0 - 15.0 ; P = .04 ) than the control group . CONCLUSIONS Supervised treadmill training improved 6-minute walk performance , treadmill walking performance , brachial artery flow-mediated dilation , and quality of life but did not improve the short physical performance battery scores of PAD participants with and without intermittent claudication .  Lower extremity resistance training improved functional performance measured by treadmill walking , quality of life , and stair climbing ability . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00106327 PURPOSE A pilot study was conducted to test the feasibility of supervised treadmill exercise training to improve functioning in study participants with peripheral arterial disease who did not have classical symptoms of intermittent claudication . METHODS For this study , 32 men and women with peripheral arterial disease but no symptoms of claudication were r and omized to exercise training or usual care .  The intervention was a 12-week supervised treadmill walking program . Outcomes included 6-minute walk distance , maximum treadmill walking distance , and 4-meter walking velocity . Participant-reported community walking ability was measured with the Walking Impairment Question naire ( WIQ ) . Inflammatory blood factor levels also were measured . RESULTS Altogether , 25 participants who completed follow-up testing were included in intention-to-treat analyses . Of 24 participants ( 58 % ) r and omized to exercise , 14 completed the entire exercise training program . The participants r and omized to the intervention showed greater improvement in their WIQ walking speed score than the control subjects ( P = .05 ) . The participants r and omized to the intervention showed improvements in their 6-minute walk distance ( 1134 + /- 347 vs 1266 + /- 295 feet ; P = .03 ) , maximal treadmill walking distance ( 389 + /- 248 vs 585 + /- 293 feet ; P < .001 ) , WIQ distance score ( 52.3 + /- 29.1 vs 63.1 + /- 25.1 ; P = .002 ) , and WIQ speed score ( 48.7 + /- 26.8 vs 59.7 + /- 22.7 ; P = .008 ) . The participants r and omized to the control condition showed improvements in maximal treadmill walking distance ( 362 + /- 180 vs 513 + /- 237 feet ; P = .014 ) . There were no significant changes in the inflammatory blood factors after exercise . CONCLUSIONS This pilot study demonstrated that a supervised treadmill walking program may be feasible and may improve functioning for individuals with peripheral arterial disease who do not have classical symptoms of intermittent claudication . Further study is needed with a larger sample to identify optimal exercise methods that improve lower extremity functioning in men and women with peripheral arterial disease who do not have intermittent claudication
Conclusion Although data are limited , there is a strong significant relationship between plantar flexor muscle strength and treadmill walking ability .
Background and Objective Exercise is a widely accepted treatment known to improve walking ability in persons with peripheral arterial disease ( PAD ) ; however , it has not been confirmed as to whether exercise improves fitness and performance-based function and , consequently , performance of activities of daily living ( ADL ) .
This systematic review aims to identify whether any mode of structured exercise improves physical fitness or performance-based tests of function and whether improvement in walking ability is related to an improvement in these outcomes .
Data Sources and Study Selection Eligible studies included r and omized controlled trials ( RCTs ) using an exercise intervention for the treatment of intermittent claudication with fitness ( including the 6-min walk ( 6MW ) , aerobic capacity , shuttle and muscle strength ) tests and performance-based tests of function as the outcomes .