Improved walking economy in patients with peripheral arterial occlusive disease
Womack, C.J.; Sieminski, D.J.; Katzel, L.I.; Yataco, A.; Gardner, A.W.
Medicine and Science in Sports and Exercise 29(10): 1286-1290
1997
ISSN/ISBN: 0195-9131 PMID: 9346157 Document Number: 480546
The effect of exercise rehabilitation on the oxygen cost of ambulation in patients with peripheral arterial occlusive disease (PAOD) was evaluated with specific emphasis on the effects of exercise rehabilitation on the slow component of ovrhdot VO-2. Because the slow component of ovrhdot VO-2 represents an increase in ovrhdot VO-2 despite constant-intensity exercise, it can profoundly affect the relative energy cost of exercise in individuals with a low functional capacity. Twenty-six patients with intermittent claudication performed treadmill walking at 2.0 mph/0% grade for 20 min or until maximal claudication pain before and after 4 months of rehabilitation. The slow component of ovrhdot VO-2 during the treadmill test was defined as the difference between the end-exercise ovrhdot VO-2 and the ovrhdot VO-2 observed at minute 3. Ankle/brachial systolic pressure index (ABI) was measured before and immediately following the exercise test. Rehabilitation consisted of 3 d cntdot wk-1 of treadmill walking for 15-30 min at 60-70% of ovrhdot VO-2peak. The slow component of ovrhdot VO-2 and end-exercise ovrhdot VO-2 at pretraining (0.75 +- 0.90 and 11.12 +- 2.10 mL cntdot kg-1 cntdot min-1) were significantly reduced after 4 months of exercise rehabilitation (-0.07 +- 1.11 and 10.07 +- 1.80 mL cntdot kg-1 cntdot min-1; P lt 0.05). Exercise rehabilitation also significantly (P lt 0.05) increased the post-exercise ABI (pre-rehabilitation = 0.36 +- 0.26, post-rehabilitation = 0.43 +- 0.25). These data suggest that 4 months of exercise rehabilitation: 1) improves walking economy in PAOD patients because of a decreased slow component of ovrhdot VO-2, and 2) increases post-exercise ABI.