Skip to main content
SpringerLink
Log in
SpringerLink
Log in

Peripheral Vascular Disease: The Beneficial Effect of Exercise in Peripheral Vascular Diseases Based on Clinical Trials

  • Chapter
  • First Online:
Exercise for Cardiovascular Disease Prevention and Treatment

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1000))

Abstract

Intermittent claudication (IC) due to peripheral artery diseases (PAD) is one of the disabling disease that can affect quality of life (QOL) and functional status of capacity. It is characterized by cramping pain which develops with exercise and eliminated by rest secondary to decrease blood flow to the muscles. The annual incidence rate is increased with age. Exercise rehabilitation has a great impact in improving the functional capacity and prevent the functional disability. The available evidences from current studies have showed that exercise therapy is considered the primary treatment in PAD, which in consequently improves the QOL. In this chapter we will illustrate the current available evidences which support exercise benefit and outcomes in PAD with IC.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Kannel WB, Mcgee DL (1985) Update on some epidemiologic features of intermittent claudication: the Framingham study. J Am Geriatr Soc 33(1):13

    Article  CAS  PubMed  Google Scholar 

  2. Dumville JC, Lee AJ, Smith FB et al (2004) The health-related quality of life of people with peripheral arterial disease in the community: the Edinburgh artery study. Br J Gen Pract 54(508):826–831

    PubMed  PubMed Central  Google Scholar 

  3. McDermott MM, Greenland P, Liu K et al (2001) Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA 286(13):1599–1606

    Article  CAS  PubMed  Google Scholar 

  4. Mcdermott MM, Greenland P, Liu K et al (2002) The ankle brachial index is associated with leg function and physical activity: the walking and leg circulation study. Ann Intern Med 136(12):873

    Article  PubMed  Google Scholar 

  5. McDermott MM, Liu K, Greenland P et al (2004) Functional decline in peripheral arterial disease: associations with the ankle brachial index and leg symptoms. JAMA 292(4):453–461

    Article  CAS  PubMed  Google Scholar 

  6. Lauret GJ, Fakhry F, Fokkenrood HJ et al (2014) Modes of exercise training for intermittent claudication. Cochrane Database Syst Rev 7:CD009638

    Google Scholar 

  7. Regensteiner JG, Hiatt WR, Coll JR et al (2008) The impact of peripheral arterial disease on health-related quality of life in the peripheral arterial disease awareness, risk, and treatment: new resources for survival (PARTNERS) program. Vasc Med 13(1):15–24

    Article  PubMed  Google Scholar 

  8. Smolderen KG, Hoeks SE, Pedersen SS et al (2009) Lower-leg symptoms in peripheral arterial disease are associated with anxiety, depression, and anhedonia. Vasc Med 14(4):297–304

    Article  PubMed  Google Scholar 

  9. Garg PK, Tian L, Criqui MH et al (2006) Physical activity during daily life and mortality in patients with peripheral arterial disease. Circulation 114(3):242–248

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hamburg NM, Balady GJ (2011) Exercise rehabilitation in peripheral artery disease: functional impact and mechanisms of benefits. Circulation 123(1):87–97

    Article  PubMed  PubMed Central  Google Scholar 

  11. Haas TL, Lloyd PG, Yang HT et al (2012) Exercise training and peripheral arterial disease. Compr Physiol 2(4):2933–3017

    PubMed  PubMed Central  Google Scholar 

  12. Stewart KJ, Hiatt WR, Regensteiner JG et al (2002) Exercise training for claudication. N Engl J Med 347(24):1941–1951

    Article  PubMed  Google Scholar 

  13. Hirsch AT, Haskal ZJ, Hertzer NR et al (2006) ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American association for vascular surgery/society for vascular surgery, society for cardiovascular angiography and interventions, society for vascular medicine and biology, society of interventional radiology, and the ACC/AHA task force on practice guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American association of cardiovascular and pulmonary rehabilitation; national heart, lung, and blood institute; society for vascular nursing; trans atlantic inter-society consensus; and vascular disease foundation. Circulation 113(11):e463–e654

    Article  PubMed  Google Scholar 

  14. Norgren L, Hiatt WR, Dormandy JA et al (2007) Inter-society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg 45(Suppl S):S5–67

    Article  PubMed  Google Scholar 

  15. Mcdermott MM, Ades P, Guralnik JM et al (2009) Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA 50(1):234–235

    Google Scholar 

  16. Medicine ACoS (2010) Guidelines for exercise testing and prescription. Lippincott Williams and Wilkens, Philadelphia

    Google Scholar 

  17. Rehabilitation AAoCaP (2004) Guidelines for cardiac rehabilitation and secondary prevention programs. Human Kinetics, Champaign

    Google Scholar 

  18. Guidon M, McGee H (2010) Exercise-based interventions and health-related quality of life in intermittent claudication: a 20-year (1989–2008) review. Eur J Cardiovasc Prev Rehabil 17(2):140–154

    Article  PubMed  Google Scholar 

  19. Spronk S, White JV, Bosch JL et al (2007) Impact of claudication and its treatment on quality of life. Semin Vasc Surg 20(1):3–9

    Article  PubMed  Google Scholar 

  20. Taft C, Karlsson J, Gelin J et al (2001) Treatment efficacy of intermittent claudication by invasive therapy, supervised physical exercise training compared to no treatment in unselected randomised patients II: one-year results of health-related quality of life. Eur J Vasc Endovasc Surg 22(2):114–123

    Article  CAS  PubMed  Google Scholar 

  21. Keo H, Grob E, Guggisberg F et al (2008) Long-term effects of supervised exercise training on walking capacity and quality of life in patients with intermittent claudication. Vasa 37(3):250–256

    Article  CAS  PubMed  Google Scholar 

  22. Fulton D, Gratton JP, McCabe TJ et al (1999) Regulation of endothelium-derived nitric oxide production by the protein kinase Akt. Nature 399(6736):597–601

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Gardner AW, Poehlman ET (1995) Exercise rehabilitation programs for the treatment of claudication pain. A meta-analysis. JAMA 274(12):975–980

    Article  CAS  PubMed  Google Scholar 

  24. Watson L, Ellis B, Leng GC (2008) Exercise for intermittent claudication. Cochrane Database Syst Rev 4:CD000990

    Google Scholar 

  25. Hankey GJ, Norman PE, Eikelboom JW (2006) Medical treatment of peripheral arterial disease. JAMA 295(5):547–553

    Article  CAS  PubMed  Google Scholar 

  26. Gokce N, Keaney JF Jr, Hunter LM et al (2003) Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events in patients with peripheral vascular disease. J Am Coll Cardiol 41(10):1769–1775

    Article  PubMed  Google Scholar 

  27. Brevetti G, Silvestro A, Schiano V et al (2003) Endothelial dysfunction and cardiovascular risk prediction in peripheral arterial disease: additive value of flow-mediated dilation to ankle-brachial pressure index. Circulation 108(17):2093–2098

    Article  PubMed  Google Scholar 

  28. Laughlin MH, Davis MJ, Secher NH et al (2012) Peripheral circulation. Compr Physiol 2(1):321–447

    Article  PubMed  Google Scholar 

  29. Andersen P, Henriksson J (1977) Capillary supply of the quadriceps femoris muscle of man: adaptive response to exercise. J Physiol 270(3):677–690

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Brodal P, Ingjer F, Hermansen L (1977) Capillary supply of skeletal muscle fibers in untrained and endurance-trained men. Am J Phys 232(6):H705–H712

    CAS  Google Scholar 

  31. Ingjer F (1978) Maximal aerobic power related to the capillary supply of the quadriceps femoris muscle in man. Acta Physiol Scand 104(2):238–240

    Article  CAS  PubMed  Google Scholar 

  32. Bendermacher BL, Willigendael EM, Teijink JA et al (2006) Supervised exercise therapy versus non-supervised exercise therapy for intermittent claudication, vol (2). Cochrane Database Syst Rev 19(2):CD005263

    Google Scholar 

  33. Thompson PDBD, Pina IL, Balady GJ, Williams MA, Marcus BH, Berra K, Blair SN, Costa F, Franklin B, Fletcher GF, Gordon NF, Pate RR, Rodriguez BL, Yancey AK, Wenger NK (2003) Exercise and physical activity in the prevention and treatment of atheroscleroticcardiovascular disease: a statement from the council on clinical cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the council on nutrition, physical activity, and metabolism (Subcommittee on Physical Activity). Circulation 107(24):3109–3116

    Article  PubMed  Google Scholar 

  34. Murphy TP, Cutlip DE, Regensteiner JG et al (2012) Supervised exercise versus primary stenting for claudication resulting from aortoiliac peripheral artery disease: six-month outcomes from the claudication: exercise versus endoluminal revascularization (CLEVER) study. Circulation 125(1):130–139

    Article  PubMed  Google Scholar 

  35. Gardner AW, Parker DE, Montgomery PS et al (2011) Efficacy of quantified home-based exercise and supervised exercise in patients with intermittent claudication: a randomized controlled trial. Circulation 123(5):491–498

    Article  PubMed  PubMed Central  Google Scholar 

  36. Asselt ADIV, Nicolaï SPA, Joore MA et al (2011) Cost-effectiveness of exercise therapy in patients with intermittent claudication: supervised exercise therapy versus a ‘Go Home and Walk’ advice. Eur J Vasc Endovasc Surg 41(1):97–103

    Article  PubMed  Google Scholar 

  37. Tuner SL, Easton C, Wilson J et al (2008) Cardiopulmonary responses to treadmill and cycle ergometry exercise in patients with peripheral vascular disease. J Vasc Surg 47(1):123–130

    Article  PubMed  Google Scholar 

  38. Zwierska I, Walker RD, Choksy SA et al (2005) Upper- vs lower-limb aerobic exercise rehabilitation in patients with symptomatic peripheral arterial disease: a randomized controlled trial. J Vasc Surg 42(6):1122

    Article  PubMed  Google Scholar 

  39. Walker RD, Nawaz S, Wilkinson CH et al (2000) Influence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication. J Vasc Surg 31(4):662–669

    Article  CAS  PubMed  Google Scholar 

  40. Bronas UG, Treat-Jacobson D, Leon AS (2011) Comparison of the effect of upper body-ergometry aerobic training vs treadmill training on central cardiorespiratory improvement and walking distance in patients with claudication. J Vasc Surg 53(6):1557–1564

    Article  PubMed  Google Scholar 

  41. Collins EG, Langbein WE, Orebaugh C et al (2005) Cardiovascular training effect associated with polestriding exercise in patients with peripheral arterial disease. J Cardiovasc Nurs 20(3):177–185

    Article  PubMed  Google Scholar 

  42. Collins EG, Edwin Langbein W, Orebaugh C et al (2003) Pole Striding exercise and vitamin E for management of peripheral vascular disease. Med Sci Sports Exerc 35(3):384–393

    Article  CAS  PubMed  Google Scholar 

  43. Langbein WE, Collins EG, Orebaugh C et al (2002) Increasing exercise tolerance of persons limited by claudication pain using polestriding. J Vasc Surg 35(5):887

    Article  PubMed  Google Scholar 

  44. Oakley C, Zwierska I, Tew G et al (2008) Nordic poles immediately improve walking distance in patients with intermittent claudication. Eur J Vasc Endovasc Surg 36(6):689–694; discussion 695–686

    Article  CAS  PubMed  Google Scholar 

  45. Collins EG, O’Connell S, McBurney C et al (2012) Comparison of walking with poles and traditional walking for peripheral arterial disease rehabilitation. J Cardiopulm Rehabil Prev 32(4):210–218

    Article  PubMed  PubMed Central  Google Scholar 

  46. Tebbutt N, Robinson L, Todhunter J et al (2011) A plantar flexion device exercise programme for patients with peripheral arterial disease: a randomised prospective feasibility study. Physiotherapy 97(3):244–249

    Article  PubMed  Google Scholar 

  47. Perkins JM, Collin J, Creasy TS et al (1996) Exercise training versus angioplasty for stable claudication. Long and medium term results of a prospective, randomised trial. Eur J Vasc Endovasc Surg 11(4):409–413

    Article  CAS  PubMed  Google Scholar 

  48. Spronk S, Bosch JL, den Hoed PT et al (2009) Intermittent claudication: clinical effectiveness of endovascular revascularization versus supervised hospital-based exercise training – randomized controlled trial. Radiology 250(2):586–595

    Article  PubMed  Google Scholar 

  49. Mazari FA, Gulati S, Rahman MN et al (2010) Early outcomes from a randomized, controlled trial of supervised exercise, angioplasty, and combined therapy in intermittent claudication. Ann Vasc Surg 24(1):69–79

    Article  CAS  PubMed  Google Scholar 

  50. Treesak C, Kasemsup V, Treat-Jacobson D et al (2004) Cost-effectiveness of exercise training to improve claudication symptoms in patients with peripheral arterial disease. Vasc Med 9(4):279–285

    Article  PubMed  Google Scholar 

  51. Lundgren F, Dahllöf AG, Lundholm K et al (1989) Intermittent claudication – surgical reconstruction or physical training? A prospective randomized trial of treatment efficiency. Ann Surg 209(3):346–355

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Bronas UG, Hirsch AT, Murphy T et al (2009) Design of the multicenter standardized supervised exercise training intervention for the claudication: exercise vs endoluminal revascularization (CLEVER) study. Vasc Med 14(4):313–321

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Associate prof., Rheumatology and Rehabilitation, Benha University Hospital, Banha, Egypt

    Basant M. Elnady

  2. National Heart Institute, Giza, Egypt

    Ayman Saeed

Authors
  1. Basant M. Elnady
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ayman Saeed
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Basant M. Elnady .

Editor information

Editors and Affiliations

  1. Cardiac Regeneration and Ageing Lab, School of Life Science, Shanghai University, Shanghai, China

    Junjie Xiao

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Elnady, B.M., Saeed, A. (2017). Peripheral Vascular Disease: The Beneficial Effect of Exercise in Peripheral Vascular Diseases Based on Clinical Trials. In: Xiao, J. (eds) Exercise for Cardiovascular Disease Prevention and Treatment. Advances in Experimental Medicine and Biology, vol 1000. Springer, Singapore. https://doi.org/10.1007/978-981-10-4304-8_11

Download citation

Publish with us

Policies and ethics

Search

Navigation