Exercise Programs in Peripheral Artery Disease

Programmed exercises are recommended as initial management strategy for patients with peripheral artery disease (PAD).

Most exercise programs include supervised treadmill walking twice or three times a week in a strategic facility (such as a gym). PAD patients often give up on these programs seeing as they might find it difficult to keep to a set timetable, and mainly because of pain.  However, these programs are not always available and, when they are, they are often expensive.

There are other exercise programs for PAD patients that can improve maximum walking distance (MWD): Nordic walking programs have been especially designed as a walking technique to reduce the load on legs using chest and arms. This has resulted in better cardiovascular exercise and fast MWD improvement. However, this technique could reduce adaptative change in legs (angiogenesis).

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This study compared standard exercise programs against the innovative Nordic technique in patients with peripheral artery disease.

5 independent studies with a total 294 patients were compared. Maximal walking distance resulted similar between patients treated with the Nordic program and those treated with standard walking programs.

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Standard completely supervised programs had different results compared against the Nordic program, though when comparing partially supervised programs or home-based programs, the Nordic program resulted superior.

Conclusion

In this systematic review, the Nordic program did not result superior when compared against standard supervised exercise programs, though it did result beneficial when comparing against partially supervised or home-based programs. Regardless, exercise should be actively recommended to our peripheral artery disease patients.

Original title: Systematic Review and Meta-analysis of Clinical Trials Examining the Benefit of Exercise Programmes Using Nordic Walking in Patients with Peripheral Artery Disease.

Reference: Jonathan Golledge et al. Eur J Vasc Endovasc Surg (2018), article in press.

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