Arm cranking is a useful alternative exercise modality for improving walking performance in patients with intermittent claudication; however, the mechanisms of such an improvement are poorly understood. The main aim of the present study was to investigate the effects of arm-crank exercise training on lower-limb O2 delivery in patients with intermittent claudication. A total of 57 patients with intermittent claudication (age, 70±8 years; mean±S.D.) were randomized to an arm-crank exercise group or a non-exercise control group. The exercise group trained twice weekly for 12 weeks. At baseline and 12 weeks, patients completed incremental tests to maximum exercise tolerance on both an arm-crank ergometer and a treadmill. Respiratory variables were measured breath-by-breath to determine peak V̇O2 (O2 uptake) and ventilatory threshold. Near-IR spectroscopy was used in the treadmill test to determine changes in calf muscle StO2 (tissue O2 saturation). Patients also completed a square-wave treadmill-walking protocol to determine V̇O2 kinetics. A total of 51 patients completed the study. In the exercise group, higher maximum walking distances (from 496±250 to 661±324 m) and peak V̇O2 values (from 17.2±2.7 to 18.2±3.4 ml·kg−1 of body mass·min−1) were recorded in the incremental treadmill test (P<0.05). After training, there was also an increase in time to minimum StO2 (from 268±305 s to 410±366 s), a speeding of V̇O2 kinetics (from 44.7±10.4 to 41.3±14.4 s) and an increase in submaximal StO2 during treadmill walking (P<0.05). There were no significant changes in the control group. The results suggest that the improvement in walking performance after arm-crank exercise training in patients with intermittent claudication is attributable, at least in part, to improved lower-limb O2 delivery.
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Research Article|
September 21 2009
Limb-specific and cross-transfer effects of arm-crank exercise training in patients with symptomatic peripheral arterial disease
Garry Tew;
Garry Tew
* Centre for Sport and Exercise Science, Collegiate Crescent Campus, Sheffield Hallam University, Sheffield S10 2BP, U.K.
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Shah Nawaz;
Shah Nawaz
† Sheffield Vascular Institute, Northern General Hospital, Sheffield S5 7AU, U.K.
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Irena Zwierska;
Irena Zwierska
* Centre for Sport and Exercise Science, Collegiate Crescent Campus, Sheffield Hallam University, Sheffield S10 2BP, U.K.
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John M. Saxton
* Centre for Sport and Exercise Science, Collegiate Crescent Campus, Sheffield Hallam University, Sheffield S10 2BP, U.K.
Correspondence: Dr John M. Saxton (email j.m.saxton@shu.ac.uk).
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Clin Sci (Lond) (2009) 117 (12): 405–413.
Article history
Received:
January 07 2009
Revision Received:
March 06 2009
Accepted:
April 23 2009
Accepted Manuscript online:
April 30 2009
Citation
Garry Tew, Shah Nawaz, Irena Zwierska, John M. Saxton; Limb-specific and cross-transfer effects of arm-crank exercise training in patients with symptomatic peripheral arterial disease. Clin Sci (Lond) 1 July 2009; 117 (12): 405–413. doi: https://doi.org/10.1042/CS20080688
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