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| Comparison of two treadmill training programs on walking ability and endothelial function in intermittent claudication |
| Mika P, Konik A, Januszek R, Petriczek T, Mika A, Nowobilski R, Nizankowski R, Szczeklik A |
| International Journal of Cardiology 2013 Sep 30;168(2):838-842 |
| clinical trial |
| 6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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BACKGROUND: In this randomized trial we compared two treadmill trainings, based on exercises performed to moderate claudication pain versus pain-free training, with respect to their effects on walking ability and endothelial function. METHODS: A total of sixty patients with stable intermittent claudication were randomized to the pain-free treadmill training (repetitive intervals to onset of claudication pain) or moderate treadmill training (repetitive intervals to moderate claudication pain). In both groups exercises were performed 3 times a week for 3 months. Changes in flow mediated dilatation (FMD) and treadmill walking performance as well as plasma levels of c-reactive protein (hs-CRP) and fibrinogen were assessed before and after the program. RESULTS: Fifty-two patients completed the training program. Post-training maximal walking time was prolonged by 100% (p < 0.001) versus 98% (p < 0.001), and pain-free walking time by 120% (p < 0.001) versus 93% (p < 0.001) in the moderate training group as compared to the pain-free training group, respectively. FMD increased by 56% (p < 0.001) in the moderate training group and by 36% (p < 0.01) in the pain-free training group. No significant changes in the levels of hs-CRP and fibrinogen were seen after treadmill program in either group. CONCLUSIONS: Both pain-free treadmill training and the moderate treadmill training have similar efficacy on walking ability in patients with claudication. The improvement of post-training FMD indicates systemic effect of both treadmill programs on endothelial function. Both programs appear to be safe therapeutic modes, since none of them escalates the inflammation. Pain-free treadmill training seems useful and effective therapeutic option for patients with claudication.
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