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• W2078236249 abstract "In their paper Dr Ng and colleagues1Ng P.W. Hollingsworth S.J. Luery H. Kumana T.J. Chaloner E.J. Intermittent claudication: exercise-increased walking distance is not related to improved cardiopulmonary fitness.Eur J Vasc Endovasc Surg. 2005; 30: 391-394Google Scholar hypothesize that in peripheral arteriopathy (PAOD) exercise-increased walking distance is not related to improved cardiopulmonary fitness but to other factors (muscle metabolism, inflammation, endothelial function). As suggested by the authors the lack of cardiovascular improvement could depend on the training protocol but also on the testing procedure employed. When programming PAOD rehabilitation, training protocols capable of improving both walking ability and cardiovascular function should be planned, with a proper combination of frequency-duration of sessions, number of bouts, periods of recovery. The authors searched for cardiovascular modifications through a protocol, that compared to others in use2Bulmer A.C. Coombes J.S. Optimising exercise training in peripheral arterial disease.Sports Med. 2004; 34: 983-1003Google Scholar has shorter duration (8 vs 12–18 weeks), sessions length (15 vs 30 min), bouts of exercise (90 s vs 3–5 min) and low total volume (360 vs 1500–2500 min). No explanation is given why this protocol was used instead of ‘alternative protocols geared towards improving cardiopulmonary fitness’. The authors base their conclusions on the lack of increase in VO2 peak or maximum heart rate. However, patients were tested on a cycle ergometer, therefore, reducing the possibility to detect the possible muscular aerobic adaptations determined by the walking program.3Pechar G.S. Mcardle W.D. Katch F.I. Magel J.R. Deluca J. Specificity of cardiorespiratory adaptation to bicycle and treadmill training.J Appl Physiol. 1974; 36: 753-756Google Scholar In addition, an unchanged-lowered maximum heart rate despite an increased exercise time could represent a positive adaptation to training (improved walking economy, cardiovascular efficiency). In our experience, in PAOD rehabilitation4Manfredini F. Conconi F. Malagoni A.M. Manfredini R. Mascoli F. Liboni A. et al.Speed rather than distance: a novel graded treadmill test to assess claudication.Eur J Vasc Endovasc Surg. 2004; 28: 303-309Google Scholar, 5Manfredini F. Conconi F. Malagoni A.M. Manfredini R. Basaglia N. Mascoli F. et al.Training guided by pain threshold speed: effects of a home-based program on claudication.Int Angiol. 2004; 23: 379-387Google Scholar walking performance and cardiovascular fitness are related. However, only when the claudication symptoms are reduced and the walking intensity is consequently increased the cardiovascular recovery is switched on. The daily application of a home-based protocol (24 weeks-3000 min: 10 min-2 times/day, 5 min/bout at maximal asymptomatic speed, 6 days/week) is followed by significant functional improvements within 4–8 weeks. Favourable modifications of resting blood pressure, heart rate at any workload, ankle pressure, and ABI become evident only later. The endpoint of PAOD patients rehabilitation cannot be ‘leg training’ but the improvement of cardiovascular fitness through properly planned walking protocols." @default.
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• W2078236249 date "2006-04-01" @default.
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• W2078236249 title "Trained Legs for Cardiovascular Fitness in Peripheral Arteriopathy" @default.
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• W2078236249 doi "https://doi.org/10.1016/j.ejvs.2005.11.024" @default.
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