Walking training at the heart rate of pain threshold improves cardiovascular function and autonomic regulation in intermittent claudication: A randomized controlled trial

Abstract Objectives This study investigated the effects of walking training (WT) on cardiovascular function and autonomic regulation in patents with intermittent claudication (IC). Design Randomized controlled trial. Methods Forty-two male patients with IC (≥50 years) were randomly allocated into tw...

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Published in:	Journal of science and medicine in sport Vol. 20; no. 10; pp. 886 - 892
Main Authors:	Chehuen, Marcel, Cucato, Gabriel G, Carvalho, Celso Ricardo F, Ritti-Dias, Raphael M, Wolosker, Nelson, Leicht, Anthony S, Forjaz, Cláudia Lúcia M
Format:	Journal Article
Language:	English
Published:	Australia Elsevier Ltd 01-10-2017 Elsevier Limited
Subjects:	Aged Ankle Atherosclerosis Autonomic modulation Blood Pressure Body mass index Cardiovascular disease Case-Control Studies Clinical trials Diabetes Electrocardiography Exercise Exercise Test - methods Exercise Therapy Fitness equipment Fitness training programs Heart rate Heart Rate - physiology Hemodynamic Humans Hypertension Intermittent Claudication - physiopathology Intermittent Claudication - therapy Male Metabolism Middle Aged Mortality Oxygen Consumption - physiology Pain Pain Threshold - physiology Patients Peripheral arterial disease Physical Medicine and Rehabilitation Physiology Sports Medicine Stroke Volume - physiology Vascular Resistance - physiology Walking Walking - physiology Walking training Brazil Peripheral arterial disease Blood pressure Autonomic modulation Hemodynamic Walking training
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Summary:	Abstract Objectives This study investigated the effects of walking training (WT) on cardiovascular function and autonomic regulation in patents with intermittent claudication (IC). Design Randomized controlled trial. Methods Forty-two male patients with IC (≥50 years) were randomly allocated into two groups: control (CG, n = 20, 30 min of stretching exercises) and WT (WTG, n = 22, 15 bouts of 2 min of walking interpolated by 2 min of upright rest—walking intensity was set at the heart rate of pain threshold). Both interventions were performed twice/week for 12 weeks. Walking capacity (maximal treadmill test), blood pressure (auscultatory), cardiac output (CO2 rebreathing), heart rate (ECG), stroke volume, systemic vascular resistance, forearm and calf vascular resistance (plethysmography), and low (LF) and high frequency (HF) components of heart rate variability and spontaneous baroreflex sensitivity were measured at baseline and after 12 weeks of the study. Results WT increased total walking distance (+302 ± 85 m, p = 0.001) and spontaneous baroreflex sensitivity (+2.13 ± 1.07 ms/mmHg, p = 0.02). Additionally, at rest, WT decreased systolic and mean blood pressures (−10 ± 3 and −5 ± 2 mmHg, p = 0.001 and p = 0.01, respectively), cardiac output (−0.37 ± 0.24 l/min, p = 0.03), heart rate (−4 ± 2 bpm, p = 0.001), forearm vascular resistance (−8.5 ± 2.8 U, p = 0.02) and LF/HF (−1.24 ± 0.99, p = 0.001). No change was observed in the CG. Conclusions In addition to increasing walking capacity, WT improved cardiovascular function and autonomic regulation in patients with IC.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23
ISSN:	1440-2440 1878-1861
DOI:	10.1016/j.jsams.2017.02.011