Intermittent Claudication: More Workouts Equals More Improvement

High-intensity interval training for intermittent claudication in a vascular rehabilitation program. J Vasc Nurs. 2006 Jun;24(2):46-9. Adams J, Ogola G, Stafford P, Koutras P, Hartman J.

This article reports an observational study investigating the safety and effectiveness of a high-intensity interval exercise program for patients with peripheral arterial disease. Patients were asked to walk on a treadmill to maximal claudication pain six times in each exercise session, with 3-minute rests in between. Once a patient could walk continuously for 6 minutes without reaching maximal pain, speed and/or grade was increased. To account for the changes in speed and grade, patients’ walking ability was measured as a rehabilitation score, calculated as the product of the two. A total of 47 patients were included in the study. Results showed overall improvement in the rehabilitation score with participation in the program, and specifically showed that participation in more exercise sessions led to greater improvement. Moreover, no adverse events occurred in the study patients, suggesting patients with peripheral arterial disease can safely tolerate high-intensity exercise programs.

“After adjusting for age, gender, and body mass index, the rehabilitation score increased by approximately 0.2 points for each additional exercise session attended. Thus a patent with a rehabilitation score of 3 on entering the program who attended 10 exercise sessions might achieve a score of 5, whereas another patient who attended all 36 sessions might achieve a score of 10.2.”

My comments:

The protocol for this study is listed in the abstract. Improvements were given as a product of both speed and grade of incline, so I can’t compare walking distance very well with the other treatment protocols. While this study was 3 times per week for 3 weeks, a lot of patients didn’t complete every treatment. The authors could compute average improvement per workout ( ~0.2 points per workout), so those who completed more workouts had more improvement in a roughly linear fashion. Patients in this protocol were only given 3 minutes rest between intervals, while the patient I am currently working with reports needing 5 minutes rest for all claudication pain to vacate. Perhaps that is why this program had a lesser number of subjects complete all the workouts.

Thanks for reading my blog. If you have any questions or comments (even hostile ones) please don’t hesitate to ask/share. If you’re reading one of my older blogs, perhaps unrelated to neck or back pain, and it helps you, please remember SpineFit Yoga for you or someone you know in the future.

Chad Reilly is a Physical Therapist, obtaining his Master’s in Physical Therapy from Northern Arizona University. He graduated Summa Cum Laude with a B.S. Exercise Science also from NAU. He is a Certified Strength and Conditioning Specialist, and holds a USA Weightlifting Club Coach Certification as well as a NASM Personal Training Certificate. Chad completed his Yoga Teacher Training at Sampoorna Yoga in Goa, India.


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