Heart Disease :: Arm exercises enhance walking distance in PAD

Patients with peripheral arterial disease (PAD) can benefit from upper-body aerobic exercises, according to a study presented at Scientific Sessions by Diane Treat-Jacobson, Ph.D., R.N., assistant professor at the University of Minnesota School of Nursing, Minneapolis. The findings of the study demonstrated significantly increased maximal walking distance and delayed onset of claudication after aerobic arm exercises.

?This is the first study showing that arm-only aerobics can provide results comparable to those seen with treadmill training,? Dr. Treat-Jacobson said.

The study included 35 patients (25 men and 10 women) with PAD. The mean age of the patients was 67 years. All had lifestyle-limiting claudication.

The patients were randomly assigned to a control group (no exercise) or to one of three exercise groups: use of a treadmill only, use of an arm ergometer only and use of both a treadmill and an ergometer.

The patients in the three exercise groups exercised three times per week for 12 weeks in one-hour supervised sessions. The onset of claudication and the maximal walking distance were measured at baseline and at the end of the 12-week period.

Patients in all three exercise groups improved their maximal walking distance, with analysis of covariance showing overall significance. While the most improvement occurred in the treadmill only group (from 486.15 to 778.52 meters, an increase of about 292 meters), arm exercises alone led to a significant increase of about 152 meters (from 441.26 meters to 593.40 meters; p = 0.01 compared with control), the equivalent of about two city blocks.

For patients who used both a treadmill and an ergometer, the maximal walking distance improved by 223 meters (from 441.28 meters to 664.37 meters; p = 0.001 compared with control).

The onset of claudication also improved in the three exercise groups, but the difference was not significant for any group compared with the control. The improvement for the arm exercises-only group was similar to that for the treadmill-only group (slightly more than 100 meters).

?We need additional studies to confirm the results, better understand why and how this works and also identify the best training regimen for patients,? Dr. Treat-Jacobson said. ?In the meantime, our results provide evidence that aerobic upper-body exercise is a pain-free alternative for patients with PAD who cannot or do not wish to perform treadmill exercises because of leg pain or some other disability.?

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