Bicycle exercise training improves ambulation in patients with peripheral artery disease

AbstractObjectiveExercise training has multiple beneficial effects in patients with arteriosclerotic diseases; however, the exact underlying mechanisms of the effects are not completely understood. This study aimed to evaluate the effectiveness of a supervised exercise program in improving gait para...

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Published in:Journal of vascular surgery 2020-03, Vol.71 (3), p.979-987
Main Authors: Haga, Makoto, MD, PhD, Hoshina, Katsuyuki, MD, PhD, Koyama, Hiroyuki, MD, PhD, Miyata, Tetsuro, MD, PhD, Ikegami, Yosuke, PhD, Murai, Akihiko, PhD, Nakamura, Yoshihiko, PhD
Format: Article
Language:English
Subjects:
Exercise training
Intermittent claudication
Peripheral artery disease
Surgery
Walking efficacy
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Summary:AbstractObjectiveExercise training has multiple beneficial effects in patients with arteriosclerotic diseases; however, the exact underlying mechanisms of the effects are not completely understood. This study aimed to evaluate the effectiveness of a supervised exercise program in improving gait parameters, including the variability and walking performance of lower limb movements, in patients with peripheral artery disease (PAD) and intermittent claudication (IC). MethodsSixteen patients with a history of PAD and IC were recruited for this study, and they completed a 3-month supervised bicycle exercise program. The ankle-brachial index and responses to quality of life (QOL) questionnaires were evaluated. Near-infrared spectroscopy was also performed to determine the hemoglobin oxygen saturation in the calf. Patients' kinematics and dynamics, including joint range of motion and muscle tension, were evaluated using an optical motion capture system. Computed tomography images of each muscle were assessed by manual outlining. Data were collected before and after the supervised bicycle exercise program, and differences were analyzed. ResultsSignificant differences were not found in step length, ankle-brachial index, and hemoglobin oxygen saturation before and after the supervised bicycle exercise program; however, IC distance ( P = .034), maximum walking distance ( P = .006), and all QOL questionnaire scores ( P < .001) showed significant improvement. Hip range of motion ( P = .035), maximum hip joint torque (right, P = .031; left, P = .044), maximum tension of the gluteus maximus muscle (right, P = .044; left, P = .042), and maximum hip joint work (right, P = .048; left, P = .043) also significantly decreased bilaterally. Computed tomography images showed a significant increase in the cross-sectional area of the abdominal, trunk, and thigh muscles but not in that of the lower leg muscles after the supervised exercise program intervention. ConclusionsIn this study, bicycle exercise training improved the QOL and walking distance and decreased hip movement. The results showed that bicycling might be as useful as walking in patients with PAD.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2019.06.188