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Short interval or continuous training programs to improve walking distance for intermittent claudication: Pilot study - 29/11/20

Doi : 10.1016/j.rehab.2020.03.004 
Béatrice Villemur a, Valérie Thoreau a, Michel Guinot b, c, Elodie Gailledrat b, d, Véronique Evra a, Céline Vermorel e, Alison Foote f, , Patrick Carpentier g, h, Jean-Luc Bosson i, Dominic Pérennou d, j
a Department of Vascular Rehabilitation, Grenoble Alpes University Hospital, 38433 Grenoble, France 
b Sports Medicine Department, Grenoble Alpes University Hospital, 38433 Grenoble, France 
c INSERM U1042, Laboratory HP2, Grenoble Alpes University Hospital, 38000 Grenoble, France 
d Department of Physical and Rehabilitation Medicine, Grenoble Alpes University Hospital, 38433 Grenoble, France 
e INSERM CIC-1406 Grenoble Alpes University Hospital, 38043 Grenoble, France 
f Research Division, Grenoble Alpes University Hospital, 38433 Grenoble, France 
g Vascular Medicine Department, Grenoble Alpes University Hospital, 38433 Grenoble, France 
h Faculty of Medicine, University Grenoble Alpes, 38000 Grenoble, France 
i TIMC-IMAG, University Grenoble Alpes, 38000 Grenoble, France 
j Lab. Cognitive Neurosciences, CNRS UMR5105, Université Grenoble Alpes, 38040 Grenoble, France 

Corresponding author. CIC-P, Hôpital Michallon, CHU de Grenoble Alpes, 38043 Grenoble, France.CIC-P, Hôpital Michallon, CHU de Grenoble AlpesGrenoble38043France

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Highlights

Adherence and tolerance to 4-week intensive rehabilitation programs were high in individuals with peripheral artery disease showing intermittent claudication.
Short 4-week intensive programs of treadmill training are effective.

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Abstract

Objective

Supervised exercise training is part of first-line therapies for intermittent claudication. Short periods of intensive treadmill training have been found efficient; however, the optimal modalities remain to be determined, especially interval training with active recovery (ITAR). In this prospective assessor-blinded single-centre pilot study, we assessed the feasibility of a randomised controlled trial comparing parallel 4-week intensive rehabilitation programs comprising treadmill training performed as ITAR or conventional training with constant slope and speed interspersed with rest periods (CT).

Methods

A total of 38 in- or out-patients were randomised to the ITAR or CT program for 5 days/week for 4weeks. The primary outcome was change in maximum walking distance measured on a graded treadmill before and after the program.

Results

Adherence was high. All training sessions were completed in the ITAR program and only a few were not completed in the CT program (median 100% [Q1–Q3 96–100]). Tolerance was excellent (no adverse events). VO2peak was low in both groups, corresponding to moderate to severe exercise intolerance. The 2 groups did not differ in the primary outcome (median ITAR vs CT 480 [135–715] vs 315m [0–710]; p=0.62) or other walking distances (constant speed and gradient treadmill test). For all 38 participants, both programs greatly increased maximum walking distance in the graded treadmill test: median 415 [240–650] to 995m [410–1490], with a large effect size (p<10−4).

Conclusion

A 4-week intensive rehabilitation program with ITAR or CT for intermittent claudication showed high adherence, was well tolerated, and improved walking distance as much as that reported for longer conventional programs. These findings prompt the design of a larger multicenter randomised controlled trial.

Trial registration

NCT01734603

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Peripheral arterial disease, Intermittent claudication, Physical therapy, Exercise physiology, Treadmill training with active recovery, Supervised exercise


Mappa


 ClinicalTrials.gov registration: NCT01734603.


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P. 466-473 - novembre 2020 Ritorno al numero
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