Supervised exercise training improves cardiorespiratory fitness and reduces perioperative risk in peripheral artery disease patients with intermittent claudication

Damien Lanéelle, Menna Hughes, Benjamin Stacey, Mohamad Bashir, Ian Williams, Michael Lewis, Damian Bailey*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Introduction: This study examined to what extent supervised aerobic and resistance exercise combined with continued unsupervised exercise training improves cardiorespiratory fitness and corresponding perioperative risk in peripheral artery disease (PAD) patients with intermittent claudication.

Materials and Methods: A total of 106 patients (77% male) were enrolled into the study, alongside 155 healthy non-PAD control participants. Patients completed supervised exercise therapy (aerobic and resistance exercises of the upper and lower limbs) twice a week for 10 weeks. Thereafter, 52 patients completed 12-weeks of an unsupervised tailored homebased exercise. Pain free walking distance (PWD), maximum walking distance (MWD), peak oxygen uptake (V̇O2PEAK) and perioperative risk were assessed before and after both exercise interventions.

Results: Patients were highly unconditioned relative to healthy controls ( ̇VO2PEAK=11.9 vs 24.2ml/kg/min,p=<0.001) with 91% classified ashigh perioperative risk (peak oxygen uptake <15ml/kg/min). Supervised exercise increased PWD (+44±81m,p=<0.001), MWD (+44±71m,p=<0.001) and ̇VO2PEAK(+1.01±1.63ml/kg/min,p=<0.001) and lowered perioperative risk (91% to 85%,p=<0.001). When compared withsupervised exercise, the improvements in PWD were maintained following unsupervised exercise (+11±91m vs supervised exercise,p=0.572);however, MWD and ̇VO2PEAKdecreased (−15±48m,p=0.030 and−0.34±1.11ml/kg/min,p=0.030, respectively) and perioperative risk increased(+3%,p=<0.001) although still below baseline (p=<0.001)

Conclusions: Supervised aerobic and resistance exercise training and, to a lesser extent, unsupervised tailored exercise improves walking capacity andcardiorespiratory fitness and reduces perioperative risk in PAD patients with intermittent claudication.
Original languageEnglish
Article number0169
Pages (from-to)185-194
Number of pages10
JournalAnnals of the Royal College of Surgeons of England
Volume106
Issue number2
Early online date2 May 2023
DOIs
Publication statusPublished - 1 Feb 2024

Keywords

  • intermittent claudication
  • Peripheral arterial disease
  • perioperative risk
  • supervised exercise
  • Cardiorespiratory fitness

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