Outcomes following supervised exercise and home-based exercise for patients with intermittent claudication

Journal article

Leslie, R., May, S., Scordis, C., Isgar, V., Poulton, P. and Garnham, A.. (2022). Outcomes following supervised exercise and home-based exercise for patients with intermittent claudication. Journal of Vascular Nursing. 40(4), pp. 157-161. https://doi.org/10.1016/j.jvn.2022.09.006
AuthorsLeslie, R., May, S., Scordis, C., Isgar, V., Poulton, P. and Garnham, A.
Abstract

Introduction
Intermittent claudication (IC) is the most common symptom of peripheral arterial disease (PAD) which presents as a consequence of muscle ischaemia resulting from the atherosclerotic obstruction to arterial flow. High-quality evidence (Lane et al., 2017) shows that exercise programmes provide important benefits compared with usual care in improving pain-free and maximum walking distance in people with IC, but do not improve ankle-brachial pressure index (ABPI).

Methods
Retrospective data were analysed to examine walking and ABPI outcomes for participants who completed a 12-week course of supervised or home-based exercise. All participants had a history of IC.

Results
46 participants (mean age 69±11 years; 76% male; 29% current smokers) referred for exercise were assessed, completed a 12-week course of exercise (home-based or supervised) and subsequently attended for re-assessment. Claudication onset distance (COD) increased by 363% (mean improvement 344.7 ± 265.1m; p < .001) and peak walking distance (PWD) by 324.4% in the supervised exercise group; COD increased by 30.6% (mean improvement 32.8 ± 57.2 m; p = 0.026) and PWD by 31.5% in the home-based exercise group. Resting ABPI for the total cohort significantly improved from 0.82 ± 0.25 at A1 to 0.88 ± 0.25 at A2 (p = 0.027).

Discussion
A 12-week course of supervised exercise results in significantly greater walking distance outcomes (COD and PWD) than unmonitored home-based exercise. In contrast with previous findings (Lane et al. 2017), this retrospective study demonstrated a significant improvement in resting ABPI with both supervised exercise as well as home-based exercise.

Conclusion
A 12-week programme of exercise favourably influenced walking and ABPI outcomes for patients with IC. Both home-based exercise and supervised individualised exercise increased walking distances, but the magnitude of the improvement in walking outcomes was greater in individuals who attended supervised exercise therapy.

Year2022
JournalJournal of Vascular Nursing
Journal citation40 (4), pp. 157-161
PublisherElsevier Inc.
ISSN1062-0303
Digital Object Identifier (DOI)https://doi.org/10.1016/j.jvn.2022.09.006
PubMed ID36435597
Scopus EID2-s2.0-85140233205
Page range157-161
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All rights reserved
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Controlled
Output statusPublished
Publication dates
Online04 Oct 2022
Publication process dates
Deposited19 Nov 2023
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Activation of mTOR signalling in young and old human skeletal muscle in response to combined resistance exercise and whey protein ingestion
Farnfield, Michelle M., Breen, Leigh, Carey, Kate A., Garnham, Andrew and Cameron-Smith, David. (2012). Activation of mTOR signalling in young and old human skeletal muscle in response to combined resistance exercise and whey protein ingestion. Applied Physiology, Nutrition and Metabolism. 37(1), pp. 21 - 30. https://doi.org/10.1139/H11-132
Low muscle glycogen concentration does not suppress the anabolic response to resistance exercise
Camera, Donny, West, D, Burd, N, Phillips, S, Garnham, A, Hawley, John and Coffey, Vernon. (2012). Low muscle glycogen concentration does not suppress the anabolic response to resistance exercise. Journal of Applied Physiology. 113(2), pp. 206 - 214. https://doi.org/10.1152/japplphysiol.00395.2012
Nutrient provision increases signalling and protein synthesis in human skeletal muscle after repeated sprints
Coffey, Vernon, Moore, Daniel, Burd, N, Rerecich, T, Stellingwerff, T, Garnham, A, Phillips, S and Hawley, John. (2011). Nutrient provision increases signalling and protein synthesis in human skeletal muscle after repeated sprints. European Journal of Applied Physiology. 111(7), pp. 1473 - 1483. https://doi.org/10.1007/s00421-010-1768-0
Impact of resistance exercise training on interleukin-6 and JAK/STAT in young men
Trenerry, Marissa K., Della Gatta, Paul A., Larsen, Amy E., Garnham, Andrew P. and Cameron-Smith, David. (2011). Impact of resistance exercise training on interleukin-6 and JAK/STAT in young men. Muscle & Nerve. 43(3), pp. 385 - 392. https://doi.org/10.1002/mus.21875
Impact of resistance exercise training on interleukin-6 and JAK/STAT in young men
Trenerry, Melissa K., Della Gatta, Paul A., Larson, Amy E. and Garnham, Andrew P.. (2011). Impact of resistance exercise training on interleukin-6 and JAK/STAT in young men. Muscle & Nerve. 43(3), pp. 385 - 392. https://doi.org/10.1002/mus.21875
Vitamin D status and musculoskeletal health in adolescent male ballet dancers a pilot study
Ducher, Gaele, Kukuljan, Sonja, Hill, B., Garnham, Andrew P., Nowson, Carol A., Kimlin, M. G. and Cook, Jill. (2011). Vitamin D status and musculoskeletal health in adolescent male ballet dancers a pilot study. Journal of Dance Medicine and Science. 15(3), pp. 99 - 107.
Current markers of the Athlete Blood Passport do not flag microdose EPO doping
Ashenden, Michael, Gough, Clare E., Garnham, Andrew, Gore, Christopher J. and Sharpe, Ken. (2011). Current markers of the Athlete Blood Passport do not flag microdose EPO doping. European Journal of Applied Physiology. 111(9), pp. 2307 - 2314. https://doi.org/10.1007/s00421-011-1867-6
Exercise training increases adipose tissue GLUT4 expression in patients with type 2 diabetes
Hussey, Sophie E., McGee, S. L., Garnham, Andrew, Wentworth, John M., Jeukendrup, A. E. and Hargreaves, M.. (2011). Exercise training increases adipose tissue GLUT4 expression in patients with type 2 diabetes. Diabetes, Obesity and Metabolism. 13(10), pp. 959 - 962. https://doi.org/10.1111/j.1463-1326.2011.01426.x
Acute signalling responses to intense endurance training commenced with low or normal muscle glycogen : Experimental Physiology-Research Paper
Yeo, W, McGee, S, Carey, A, Paton, C, Garnham, A, Hargreaves, M and Hawley, John. (2010). Acute signalling responses to intense endurance training commenced with low or normal muscle glycogen : Experimental Physiology-Research Paper. Experimental Physiology. 95(2), pp. 351 - 358. https://doi.org/10.1113/expphysiol.2009.049353
Cytokine responses to carbohydrate ingestion during recovery from exercise-induced muscle injury
Ross, M, Halson, Shona, Suzuki, K, Garnham, A, Hawley, John, Cameron-Smith, David and Peake, J. (2010). Cytokine responses to carbohydrate ingestion during recovery from exercise-induced muscle injury. Journal of Interferon and Cytokine Research. 30(5), pp. 329 - 337. https://doi.org/10.1089/jir.2009.0079
Effect of consecutive repeated sprint and resistance exercise bouts on acute adaptive responses in human skeletal muscle
Coffey, Vernon Glenn, Jemiolo, Bozena, Edge, Johann, Garnham, Andrew P., Trappe, Scott W. and Hawley, John Alan. (2009). Effect of consecutive repeated sprint and resistance exercise bouts on acute adaptive responses in human skeletal muscle. American Journal of Physiology - Regulatory Integrative and Comparative Physiology. 297(5), pp. 1441 - 1451. https://doi.org/10.1152/ajpregu.00351.2009
Consecutive bouts of diverse contractile activity alter acute responses in human skeletal muscle
Coffey, Vernon Glenn, Pilegaard, Henriette, Garnham, Andrew P., O'Brien, Brendan J. and Hawley, John Alan. (2009). Consecutive bouts of diverse contractile activity alter acute responses in human skeletal muscle. Journal of Applied Physiology. 106(4), pp. 1187 - 1197. https://doi.org/10.1152/japplphysiol.91221.2008
Skeletal muscle adaptation and performance responses to once a day versus twice every second day endurance training regimens
Yeo, Wee Kian, Paton, Carl D., Garnham, Andrew P., Burke, Louise M., Carey, Andrew L. and Hawley, John Alan. (2008). Skeletal muscle adaptation and performance responses to once a day versus twice every second day endurance training regimens. Journal of Applied Physiology. 105(5), pp. 1462 - 1470. https://doi.org/10.1152/japplphysiol.90882.2008
Fat adaptation followed by carbohydrate restoration increases AMPK activity in skeletal muscle from trained humans
Yeo, Wee Kian, Lessard, Sarah J., Chen, Zhi-Ping, Garnham, Andrew P., Burke, Louise, Rivas, Donato A., Kemp, Bruce Ernest and Hawley, John Alan. (2008). Fat adaptation followed by carbohydrate restoration increases AMPK activity in skeletal muscle from trained humans. Journal of Applied Physiology. 105(5), pp. 1519 - 1526. https://doi.org/10.1152/japplphysiol.90540.2008